Tıp Terimleri Sözlüğü

The major complication of in vitro fertilization (IVF) is the development of multiple births. This is directly related to the practice of placing multiple embryos at embryo transfer. Multiple births are related to increased pregnancy loss, obstetrical complications, prematurity, and neonatal morbidity with the potential for long term damage. Strict embryo transfer policies have been enacted to reduce this problem, but are not universally followed or accepted. Recent evidence suggest that singleton offspring after IVF is at higher risk for lower birth weight for unknown reasons. The issue of birth defects remains a controversial topic in IVF. A majority of studies do not show a significant increase after use of IVF. Some studies suggest higher rates for intracytoplasmic sperm injection (ICSI), while others do not support this finding. Major birth defects include chromosomal abnormalities, genetic imprinting defects, and multiple organ abnormalities. Possible explanations for birth defects offered were the underlying cause of the infertility, factors associated with IVF/ICSI, culture conditions, and medications, however, the actual cause is not known.

Parçaya göre, aşağıdakilerden hangisi IVF tedavisinin başlıca komplikasyonudur?

• Konjenital anomali
• Düşük doğum ağırlığı
• Neonatal morbidite
• Çoğul gebelik
• Gebelik kaybı

The major complication of in vitro fertilization (IVF) is the development of multiple births. This is directly related to the practice of placing multiple embryos at embryo transfer. Multiple births are related to increased pregnancy loss, obstetrical complications, prematurity, and neonatal morbidity with the potential for long term damage. Strict embryo transfer policies have been enacted to reduce this problem, but are not universally followed or accepted. Recent evidence suggest that singleton offspring after IVF is at higher risk for lower birth weight for unknown reasons. The issue of birth defects remains a controversial topic in IVF. A majority of studies do not show a significant increase after use of IVF. Some studies suggest higher rates for intracytoplasmic sperm injection (ICSI), while others do not support this finding. Major birth defects include chromosomal abnormalities, genetic imprinting defects, and multiple organ abnormalities. Possible explanations for birth defects offered were the underlying cause of the infertility, factors associated with IVF/ICSI, culture conditions, and medications, however, the actual cause is not known.

Parçada, aşağıdakilerin hangisinden yaygın olarak uyulmayan veya kabul görmeyen sıkı politika olarak söz edilmiştir?

• Erken doğum
• Abortus
• ICSI
• IVF
• Embriyo transferi

The major complication of in vitro fertilization (IVF) is the development of multiple births. This is directly related to the practice of placing multiple embryos at embryo transfer. Multiple births are related to increased pregnancy loss, obstetrical complications, prematurity, and neonatal morbidity with the potential for long term damage. Strict embryo transfer policies have been enacted to reduce this problem, but are not universally followed or accepted. Recent evidence suggest that singleton offspring after IVF is at higher risk for lower birth weight for unknown reasons. The issue of birth defects remains a controversial topic in IVF. A majority of studies do not show a significant increase after use of IVF. Some studies suggest higher rates for intracytoplasmic sperm injection (ICSI), while others do not support this finding. Major birth defects include chromosomal abnormalities, genetic imprinting defects, and multiple organ abnormalities. Possible explanations for birth defects offered were the underlying cause of the infertility, factors associated with IVF/ICSI, culture conditions, and medications, however, the actual cause is not known.

Parçada, yakın zamanda edinilen kanıtların, IVF tedavisiyle gerçekleşen tekil gebeliklerdeki düşük doğum ağırlığını aşağıdakilerden hangisine bağladığı belirtilmektedir?

• Bilinmeyen nedenlere
• İnfertiliteye
• Prematüriteye
• Anomalilere
• IVF yönteminin kendisine

The major complication of in vitro fertilization (IVF) is the development of multiple births. This is directly related to the practice of placing multiple embryos at embryo transfer. Multiple births are related to increased pregnancy loss, obstetrical complications, prematurity, and neonatal morbidity with the potential for long term damage. Strict embryo transfer policies have been enacted to reduce this problem, but are not universally followed or accepted. Recent evidence suggest that singleton offspring after IVF is at higher risk for lower birth weight for unknown reasons. The issue of birth defects remains a controversial topic in IVF. A majority of studies do not show a significant increase after use of IVF. Some studies suggest higher rates for intracytoplasmic sperm injection (ICSI), while others do not support this finding. Major birth defects include chromosomal abnormalities, genetic imprinting defects, and multiple organ abnormalities. Possible explanations for birth defects offered were the underlying cause of the infertility, factors associated with IVF/ICSI, culture conditions, and medications, however, the actual cause is not known.

Parçada doğum defektleriyle ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• Majör defektler arasında kromozom bozuklukları vardır.
• Birden fazla organda anormallikler görülebilir.
• Genetik kodlama anormallikleri majör defektler arasındadır.
• Çalışmaların çoğu IVF ile ilişkili olarak önemli bir artış olduğunu göstermiştir.
• Bazı çalışmalar ICSI sonrası artış iddia etmişlerdir.

The major complication of in vitro fertilization (IVF) is the development of multiple births. This is directly related to the practice of placing multiple embryos at embryo transfer. Multiple births are related to increased pregnancy loss, obstetrical complications, prematurity, and neonatal morbidity with the potential for long term damage. Strict embryo transfer policies have been enacted to reduce this problem, but are not universally followed or accepted. Recent evidence suggest that singleton offspring after IVF is at higher risk for lower birth weight for unknown reasons. The issue of birth defects remains a controversial topic in IVF. A majority of studies do not show a significant increase after use of IVF. Some studies suggest higher rates for intracytoplasmic sperm injection (ICSI), while others do not support this finding. Major birth defects include chromosomal abnormalities, genetic imprinting defects, and multiple organ abnormalities. Possible explanations for birth defects offered were the underlying cause of the infertility, factors associated with IVF/ICSI, culture conditions, and medications, however, the actual cause is not known.

Aşağıdakilerden hangisi parçada belirtilen olası doğum defekti nedenlerinden biri değildir?

• Altta yatan infertilite nedeni
• IVF/ICSI bağlantılı faktörler
• Kültür koşulları
• Kullanılan ilaçlar
• Çok sayıda embriyo transferi

Obesity may become evident at any age, but it appears at 5-6 years of age, during adolescence, and most frequently in the 1st year of life. Children whose obesity is due to excessively high caloric intake are usually not only heavier than others in their own cohort but also taller, and bone age is advanced. The facial features often appear disproportionately fine. The adiposity in the mammary regions of boys is often suggestive of breast development and, therefore, may be an embarrassing feature. The abdomen tends to be pendulous, and white or purple striae are often present. The external genitalia of boys appear disproportionately small but actually are most often of average size; the penis is often embedded in the pubic fat. Puberty may occur early, with the result that the ultimate height of obese individuals may be less than that of their slower maturing peers. The development of the external genitalia is normal in most girls, and menarche is usually not delayed and may be advanced. Obesity of the extremities is usually greater in the upper arm and thigh and is sometimes limited to them. The hands may be relatively small and the fingers tapering.

Parçaya göre, obezitenin en sık ne zaman görüldüğü belirtilmektedir?

• Herhangi bir yaşta
• Hayatın ilk 1 yılı içinde
• Hayatın ilk 5-6 yılı içinde
• Ergenliğe kadar
• Erişkinlikte

Obesity may become evident at any age, but it appears at 5-6 years of age, during adolescence, and most frequently in the 1st year of life. Children whose obesity is due to excessively high caloric intake are usually not only heavier than others in their own cohort but also taller, and bone age is advanced. The facial features often appear disproportionately fine. The adiposity in the mammary regions of boys is often suggestive of breast development and, therefore, may be an embarrassing feature. The abdomen tends to be pendulous, and white or purple striae are often present. The external genitalia of boys appear disproportionately small but actually are most often of average size; the penis is often embedded in the pubic fat. Puberty may occur early, with the result that the ultimate height of obese individuals may be less than that of their slower maturing peers. The development of the external genitalia is normal in most girls, and menarche is usually not delayed and may be advanced. Obesity of the extremities is usually greater in the upper arm and thigh and is sometimes limited to them. The hands may be relatively small and the fingers tapering.

Parçada çocukluk dönemi obezitesiyle ilgili olarak aşağıdakilerden hangisi söylenmemiştir?

• Sadece yüksek kalorili gıda tüketenler daha kiloludurlar.
• Yaşıtlarına göre daha uzun boyludurlar.
• Yaşıtlarına göre kemik yaşları daha gelişmiştir.
• Sıklıkla yüz hatları orantısız şekilde incedir.
• Karınları sarkıktır.

Obesity may become evident at any age, but it appears at 5-6 years of age, during adolescence, and most frequently in the 1st year of life. Children whose obesity is due to excessively high caloric intake are usually not only heavier than others in their own cohort but also taller, and bone age is advanced. The facial features often appear disproportionately fine. The adiposity in the mammary regions of boys is often suggestive of breast development and, therefore, may be an embarrassing feature. The abdomen tends to be pendulous, and white or purple striae are often present. The external genitalia of boys appear disproportionately small but actually are most often of average size; the penis is often embedded in the pubic fat. Puberty may occur early, with the result that the ultimate height of obese individuals may be less than that of their slower maturing peers. The development of the external genitalia is normal in most girls, and menarche is usually not delayed and may be advanced. Obesity of the extremities is usually greater in the upper arm and thigh and is sometimes limited to them. The hands may be relatively small and the fingers tapering.

Parçada aşağıdakilerden hangisinin erkek çocuklar için utanç kaynağı olabileceği söylenmektedir?

• Karın cildindeki mor veya beyaz çizgiler
• Pubik yağ dokusu içine gömülmüş penis görünümü
• Göğüslerde meme gelişimini andıran yağlanma
• Dış genital organlardaki orantısız küçüklük
• Yaşına göre hızlı vücut gelişimi

Obesity may become evident at any age, but it appears at 5-6 years of age, during adolescence, and most frequently in the 1st year of life. Children whose obesity is due to excessively high caloric intake are usually not only heavier than others in their own cohort but also taller, and bone age is advanced. The facial features often appear disproportionately fine. The adiposity in the mammary regions of boys is often suggestive of breast development and, therefore, may be an embarrassing feature. The abdomen tends to be pendulous, and white or purple striae are often present. The external genitalia of boys appear disproportionately small but actually are most often of average size; the penis is often embedded in the pubic fat. Puberty may occur early, with the result that the ultimate height of obese individuals may be less than that of their slower maturing peers. The development of the external genitalia is normal in most girls, and menarche is usually not delayed and may be advanced. Obesity of the extremities is usually greater in the upper arm and thigh and is sometimes limited to them. The hands may be relatively small and the fingers tapering.

Parçada erken puberteye giren çocuklar ile onların yavaş olgunlaşan akranları, aşağıdakilerden hangisi bakımından karşılaştırılmıştır?

• Boy
• Dış genital organ gelişimi
• Ellerin ve parmakların görünümü
• Yağ dağılım bölgeleri
• Ekstremiteler

Obesity may become evident at any age, but it appears at 5-6 years of age, during adolescence, and most frequently in the 1st year of life. Children whose obesity is due to excessively high caloric intake are usually not only heavier than others in their own cohort but also taller, and bone age is advanced. The facial features often appear disproportionately fine. The adiposity in the mammary regions of boys is often suggestive of breast development and, therefore, may be an embarrassing feature. The abdomen tends to be pendulous, and white or purple striae are often present. The external genitalia of boys appear disproportionately small but actually are most often of average size; the penis is often embedded in the pubic fat. Puberty may occur early, with the result that the ultimate height of obese individuals may be less than that of their slower maturing peers. The development of the external genitalia is normal in most girls, and menarche is usually not delayed and may be advanced. Obesity of the extremities is usually greater in the upper arm and thigh and is sometimes limited to them. The hands may be relatively small and the fingers tapering.

Parçada obezitenin vücut gelişimi üzerindeki etkileri arasında aşağıdakilerden hangisi sayılmamıştır?

• Uçlara doğru incelen el parmakları ve küçük eller
• Erişkinlikte boy kısalığı
• Kız çocuklarında ilk adet yaşında gecikme
• Özellikle üst kol ve uyluk bölgelerinde şişmanlık
• Ergenliğe erken yaşta girilmesi

A 52-year-old man with diabetes reported a 3-month history of a pretibial rash during a routine visit. He had a 15-year history of type 2 diabetes mellitus treated with insulin and a 3-year history of congestive heart failure. The lesions had begun to ulcerate and bleed but were not pruritic or painful. Physical examination showed yellow-brown plaques with ulcerations and telangiectases in the thinned epidermis. A diagnosis of necrobiosis lipoidica diabeticorum – an inflammatory skin disorder characterized by irregularly shaped, callous lesions with reddish-brown pigmentation and central atrophy – was made on the basis of visual inspection. In necrobiosis lipoidica diabeticorum, the shins, ankles, and feet are typically affected, but 15% of patients may have lesions elsewhere. The disorder is more common among women than men and is more common among persons with diabetes than those without. The exact cause is unknown. Treatment may include occlusive dressings, topical and subcutaneous corticosteroids, antiplatelet therapy and antibiotics when necessary. In necrobiosis lipoidica diabeticorum, flare-ups are frequent; and, no treatment is completely effective. The patient was referred to a dermatologist for continuing care, but he died suddenly at home.

Parçada rutin doktor kontrolüne geldiği söylenen hastanın özellikleri arasında aşağıdakilerden hangisi sayılmamıştır?

• 15 yıldır tip 2 diyabeti vardır.
• İnsülin kullanmaktadır.
• 3 aydır ciltte kırmızı lekeler vardır.
• 3 yıldır kalp yetmezliği vardır.
• Kanayan mide ülseri öyküsü vermiştir.

A 52-year-old man with diabetes reported a 3-month history of a pretibial rash during a routine visit. He had a 15-year history of type 2 diabetes mellitus treated with insulin and a 3-year history of congestive heart failure. The lesions had begun to ulcerate and bleed but were not pruritic or painful. Physical examination showed yellow-brown plaques with ulcerations and telangiectases in the thinned epidermis. A diagnosis of necrobiosis lipoidica diabeticorum – an inflammatory skin disorder characterized by irregularly shaped, callous lesions with reddish-brown pigmentation and central atrophy – was made on the basis of visual inspection. In necrobiosis lipoidica diabeticorum, the shins, ankles, and feet are typically affected, but 15% of patients may have lesions elsewhere. The disorder is more common among women than men and is more common among persons with diabetes than those without. The exact cause is unknown. Treatment may include occlusive dressings, topical and subcutaneous corticosteroids, antiplatelet therapy and antibiotics when necessary. In necrobiosis lipoidica diabeticorum, flare-ups are frequent; and, no treatment is completely effective. The patient was referred to a dermatologist for continuing care, but he died suddenly at home.

Parçada sözü edilen olgunun lezyonlarıyla ilgili olarak aşağıdakilerden hangisi yanlıştır?

• Ağrıya neden olmuyor.
• İncelmiş deri üzerinde sarı-kahverengi plaklar mevcut.
• İncelmiş deri üzerinde telenjektazi görünümü var.
• Ülsere lezyondan kanama olduğu ifade ediliyor.
• En belirgin özelliği kaşıntı yapmasıdır.

A 52-year-old man with diabetes reported a 3-month history of a pretibial rash during a routine visit. He had a 15-year history of type 2 diabetes mellitus treated with insulin and a 3-year history of congestive heart failure. The lesions had begun to ulcerate and bleed but were not pruritic or painful. Physical examination showed yellow-brown plaques with ulcerations and telangiectases in the thinned epidermis. A diagnosis of necrobiosis lipoidica diabeticorum – an inflammatory skin disorder characterized by irregularly shaped, callous lesions with reddish-brown pigmentation and central atrophy – was made on the basis of visual inspection. In necrobiosis lipoidica diabeticorum, the shins, ankles, and feet are typically affected, but 15% of patients may have lesions elsewhere. The disorder is more common among women than men and is more common among persons with diabetes than those without. The exact cause is unknown. Treatment may include occlusive dressings, topical and subcutaneous corticosteroids, antiplatelet therapy and antibiotics when necessary. In necrobiosis lipoidica diabeticorum, flare-ups are frequent; and, no treatment is completely effective. The patient was referred to a dermatologist for continuing care, but he died suddenly at home.

Parçada sözü edilen olguya konulan "necrobiosis lipoidica diabeticorum" tanısıyla ilgili olarak aşağıdakilerden hangisi söylenmemiştir?

• Tipik olarak baldırlar, ayaklar ve ayak bilekleri etkilenir.
• Olguların % 15’inde baldırlar, ayaklar ve ayak bileklerinde başka tip lezyonlar da bulunabilir.
• Kadınlarda erkeklerden daha sık görülür.
• Diyabeti olanlarda olmayanlara göre daha sık görülür.
• Nedeni belirsizdir.

A 52-year-old man with diabetes reported a 3-month history of a pretibial rash during a routine visit. He had a 15-year history of type 2 diabetes mellitus treated with insulin and a 3-year history of congestive heart failure. The lesions had begun to ulcerate and bleed but were not pruritic or painful. Physical examination showed yellow-brown plaques with ulcerations and telangiectases in the thinned epidermis. A diagnosis of necrobiosis lipoidica diabeticorum – an inflammatory skin disorder characterized by irregularly shaped, callous lesions with reddish-brown pigmentation and central atrophy – was made on the basis of visual inspection. In necrobiosis lipoidica diabeticorum, the shins, ankles, and feet are typically affected, but 15% of patients may have lesions elsewhere. The disorder is more common among women than men and is more common among persons with diabetes than those without. The exact cause is unknown. Treatment may include occlusive dressings, topical and subcutaneous corticosteroids, antiplatelet therapy and antibiotics when necessary. In necrobiosis lipoidica diabeticorum, flare-ups are frequent; and, no treatment is completely effective. The patient was referred to a dermatologist for continuing care, but he died suddenly at home.

Aşağıdakilerden hangisi parçada sayılan tedavi yöntemlerinden biri değildir?

• Lezyonları tamamen kapatan uzun ve sıkı giysiler
• Bölgesel kortikosteroidler
• Cilt altı kortikosteroidler
• Anti-plateletler
• Antibiyotikler

A 52-year-old man with diabetes reported a 3-month history of a pretibial rash during a routine visit. He had a 15-year history of type 2 diabetes mellitus treated with insulin and a 3-year history of congestive heart failure. The lesions had begun to ulcerate and bleed but were not pruritic or painful. Physical examination showed yellow-brown plaques with ulcerations and telangiectases in the thinned epidermis. A diagnosis of necrobiosis lipoidica diabeticorum – an inflammatory skin disorder characterized by irregularly shaped, callous lesions with reddish-brown pigmentation and central atrophy – was made on the basis of visual inspection. In necrobiosis lipoidica diabeticorum, the shins, ankles, and feet are typically affected, but 15% of patients may have lesions elsewhere. The disorder is more common among women than men and is more common among persons with diabetes than those without. The exact cause is unknown. Treatment may include occlusive dressings, topical and subcutaneous corticosteroids, antiplatelet therapy and antibiotics when necessary. In necrobiosis lipoidica diabeticorum, flare-ups are frequent; and, no treatment is completely effective. The patient was referred to a dermatologist for continuing care, but he died suddenly at home.

Parçada sözü edilen olgunun prognozuyla ilgili olarak aşağıdaki hangisi doğrudur?

• Hastalığında sık sık alevlenmeler olmuştur.
• Evinde aniden ölmüştür.
• Tedaviler tamamen etkisiz kalmıştır.
• Bir cildiye uzmanı başından itibaren tedaviyi üstlenmiştir.
• Bakımına devam edilmemiş, kendi haline bırakılmıştır.

Women whose mothers or sisters had breast cancer are more likely to develop the disease than controls. Risk is increased when breast cancer has occurred before menopause, was bilateral, or was present in 2 or more first-degree relatives. However, there is no history of breast cancer among female relatives in over 90% of patients with breast cancer. Nulliparous women have a slightly higher incidence of breast cancer than multiparous women. Late menarche and artificial menopause are associated with a lower incidence of breast cancer, whereas early menarche and late natural menopause are associated with a slight increase in risk of developing breast cancer. Fibrocystic change of the breast, when accompanied by proliferative changes, papillomatosis, or atypical epithelial hyperplasia, is associated with an increased incidence of cancer. A woman who has had cancer in one breast is at increased risk of developing cancer in the other breast. Women with endometrial cancer have a breast cancer risk significantly higher than that of the general population, and women with breast cancer have a comparably increased risk of endometrial cancer. In the US, breast cancer is more common in whites than in nonwhites. The incidence of the disease among nonwhites (mostly blacks), however, is increasing, especially in younger women. In general, rates reported from developing countries are low, whereas rates are high in developed countries, with the notable exception of Japan. Some of the variability may be due to underreporting in the developing countries, but a real difference probably exists.

Parçada soy geçmişte meme kanserinin bulunması durumunda, aşağıdaki özelliklerden hangisinin hastalık riskini artırdığı iddia edilmemiştir?

• Annede pozitif öykü
• Kız kardeşte pozitif öykü
• Birden fazla ikinci derecede akrabada pozitif öykü
• Menopozdan önceki hastalık öyküsü
• İki taraflı hastalık öyküsü

Women whose mothers or sisters had breast cancer are more likely to develop the disease than controls. Risk is increased when breast cancer has occurred before menopause, was bilateral, or was present in 2 or more first-degree relatives. However, there is no history of breast cancer among female relatives in over 90% of patients with breast cancer. Nulliparous women have a slightly higher incidence of breast cancer than multiparous women. Late menarche and artificial menopause are associated with a lower incidence of breast cancer, whereas early menarche and late natural menopause are associated with a slight increase in risk of developing breast cancer. Fibrocystic change of the breast, when accompanied by proliferative changes, papillomatosis, or atypical epithelial hyperplasia, is associated with an increased incidence of cancer. A woman who has had cancer in one breast is at increased risk of developing cancer in the other breast. Women with endometrial cancer have a breast cancer risk significantly higher than that of the general population, and women with breast cancer have a comparably increased risk of endometrial cancer. In the US, breast cancer is more common in whites than in nonwhites. The incidence of the disease among nonwhites (mostly blacks), however, is increasing, especially in younger women. In general, rates reported from developing countries are low, whereas rates are high in developed countries, with the notable exception of Japan. Some of the variability may be due to underreporting in the developing countries, but a real difference probably exists.

Parçaya göre, meme kanseriyle ilgili olarak aşağıdakilerden hangisi yanlıştır?

• Olguların çok büyük bir kısmında ailede kanser öyküsü yoktur.
• İlk adet yaşının küçük olması riski artırır.
• Gelişmekte olan toplumlarda gelişmiş toplumlara göre daha az görülür.
• Gelişmekte olan toplumlarda hastalık bildirimi gerçek sayının altında olabilir.
• Kadınlarda yaş ilerledikçe kanser sıklığı da artar.

Women whose mothers or sisters had breast cancer are more likely to develop the disease than controls. Risk is increased when breast cancer has occurred before menopause, was bilateral, or was present in 2 or more first-degree relatives. However, there is no history of breast cancer among female relatives in over 90% of patients with breast cancer. Nulliparous women have a slightly higher incidence of breast cancer than multiparous women. Late menarche and artificial menopause are associated with a lower incidence of breast cancer, whereas early menarche and late natural menopause are associated with a slight increase in risk of developing breast cancer. Fibrocystic change of the breast, when accompanied by proliferative changes, papillomatosis, or atypical epithelial hyperplasia, is associated with an increased incidence of cancer. A woman who has had cancer in one breast is at increased risk of developing cancer in the other breast. Women with endometrial cancer have a breast cancer risk significantly higher than that of the general population, and women with breast cancer have a comparably increased risk of endometrial cancer. In the US, breast cancer is more common in whites than in nonwhites. The incidence of the disease among nonwhites (mostly blacks), however, is increasing, especially in younger women. In general, rates reported from developing countries are low, whereas rates are high in developed countries, with the notable exception of Japan. Some of the variability may be due to underreporting in the developing countries, but a real difference probably exists.

Parçada aşağıdakilerden hangisi, meme kanseri riskini artıran epidemiyolojik özellikler arasında sayılmamıştır?

• Doğurmamışlık
• Kadının doğumdan sonra bebeğini emzirmemesi
• Geç yaşta menopoz
• Tek memede kanser öyküsü
• Fibrokistik hastalığa eşlik eden proliferatif değişiklikler

Women whose mothers or sisters had breast cancer are more likely to develop the disease than controls. Risk is increased when breast cancer has occurred before menopause, was bilateral, or was present in 2 or more first-degree relatives. However, there is no history of breast cancer among female relatives in over 90% of patients with breast cancer. Nulliparous women have a slightly higher incidence of breast cancer than multiparous women. Late menarche and artificial menopause are associated with a lower incidence of breast cancer, whereas early menarche and late natural menopause are associated with a slight increase in risk of developing breast cancer. Fibrocystic change of the breast, when accompanied by proliferative changes, papillomatosis, or atypical epithelial hyperplasia, is associated with an increased incidence of cancer. A woman who has had cancer in one breast is at increased risk of developing cancer in the other breast. Women with endometrial cancer have a breast cancer risk significantly higher than that of the general population, and women with breast cancer have a comparably increased risk of endometrial cancer. In the US, breast cancer is more common in whites than in nonwhites. The incidence of the disease among nonwhites (mostly blacks), however, is increasing, especially in younger women. In general, rates reported from developing countries are low, whereas rates are high in developed countries, with the notable exception of Japan. Some of the variability may be due to underreporting in the developing countries, but a real difference probably exists.

Parçaya göre, meme kanseri sıklığını artırmanın yanında, meme kanseri durumunda görülme olasılığı yüksek olan hastalık aşağıdakilerden hangisidir?

• Endometrial kanser
• Atipik epitelial hiperplazi
• Memede proliferatif değişiklikler
• Papillomatoz
• Fibrokistik hastalık

Women whose mothers or sisters had breast cancer are more likely to develop the disease than controls. Risk is increased when breast cancer has occurred before menopause, was bilateral, or was present in 2 or more first-degree relatives. However, there is no history of breast cancer among female relatives in over 90% of patients with breast cancer. Nulliparous women have a slightly higher incidence of breast cancer than multiparous women. Late menarche and artificial menopause are associated with a lower incidence of breast cancer, whereas early menarche and late natural menopause are associated with a slight increase in risk of developing breast cancer. Fibrocystic change of the breast, when accompanied by proliferative changes, papillomatosis, or atypical epithelial hyperplasia, is associated with an increased incidence of cancer. A woman who has had cancer in one breast is at increased risk of developing cancer in the other breast. Women with endometrial cancer have a breast cancer risk significantly higher than that of the general population, and women with breast cancer have a comparably increased risk of endometrial cancer. In the US, breast cancer is more common in whites than in nonwhites. The incidence of the disease among nonwhites (mostly blacks), however, is increasing, especially in younger women. In general, rates reported from developing countries are low, whereas rates are high in developed countries, with the notable exception of Japan. Some of the variability may be due to underreporting in the developing countries, but a real difference probably exists.

Parçada meme kanserinin ırklara göre dağılımıyla ilgili olarak aşağıdakilerden hangisi belirtilmemiştir?

• Beyaz ırkta daha sık görülür.
• Beyaz olmayan ırklarda sıklığı giderek artmaktadır.
• Sıklığı özellikle siyah ırkta artmaktadır.
• Sıklığı özellikle beyaz olmayan genç kadınlarda artmaktadır.
• Japon ırkında gelişmekte olan ülkelerdekine göre daha sıktır.

Telomeres are short, repeated sequences of TTAGGG at the end of human chromosomes that shorten with each cell replication unless repaired by telomerase, an enzyme with some presence in cells such as lymphocytes and germ line cells. Reduction in telomere length may be an indicator of cellular aging. During normal aging, the gradual loss of telomeric DNA in dividing somatic cells can contribute to replicative senescence, apoptosis, or neoplastic transformation. In addition, high levels of oxidative stress have been shown to lead to reduction of telomere length. Interindividual variability in humans is high, with telomere lengths shown to vary widely even among individuals of the same age. There is evidence that telomere length is a heritable characteristic, as well as related to cardiovascular stressors or psychological stress. Thus, differences in leukocyte telomere length, even among individuals of the same chronological age, may be a marker for rate of biological aging, may be related to familial differences in longevity, and may be related to risk for mortality. The association of telomere length with mortality might also represent an effect of other processes that cause both accelerated telomere shortening and mortality, for example, increased numbers of cell divisions due to stress, in the form of infections, exposure to other deleterious environmental agents or cardiovascular risk factors, and psychological stressors.

Parçada telomerlerin özellikleriyle ilgili olarak aşağıdakilerden hangisi belirtilmemiştir?

• Lenfosit ve üreme hücre hatlarında görülmez.
• Kısa, tekrarlayan, ardışık TTAGGG dizilimi gösterir.
• Her bir hücre kopyalanmasında kısalır.
• Telomeraz enzimi ile onarılır.
• İnsan kromozomlarının uçlarında bulunur.

Telomeres are short, repeated sequences of TTAGGG at the end of human chromosomes that shorten with each cell replication unless repaired by telomerase, an enzyme with some presence in cells such as lymphocytes and germ line cells. Reduction in telomere length may be an indicator of cellular aging. During normal aging, the gradual loss of telomeric DNA in dividing somatic cells can contribute to replicative senescence, apoptosis, or neoplastic transformation. In addition, high levels of oxidative stress have been shown to lead to reduction of telomere length. Interindividual variability in humans is high, with telomere lengths shown to vary widely even among individuals of the same age. There is evidence that telomere length is a heritable characteristic, as well as related to cardiovascular stressors or psychological stress. Thus, differences in leukocyte telomere length, even among individuals of the same chronological age, may be a marker for rate of biological aging, may be related to familial differences in longevity, and may be related to risk for mortality. The association of telomere length with mortality might also represent an effect of other processes that cause both accelerated telomere shortening and mortality, for example, increased numbers of cell divisions due to stress, in the form of infections, exposure to other deleterious environmental agents or cardiovascular risk factors, and psychological stressors.

Parçada telomerik kısalmanın ve DNA kaybının, aşağıdakilerden hangisine yol açtığından söz edilmemiştir?

• Hücre yaşlanması
• Programlı hücre ölümü
• Neoplastik dönüşüm
• Hücre kopyalanmasında yaşlanma
• Oksidatif stres artışı

Telomeres are short, repeated sequences of TTAGGG at the end of human chromosomes that shorten with each cell replication unless repaired by telomerase, an enzyme with some presence in cells such as lymphocytes and germ line cells. Reduction in telomere length may be an indicator of cellular aging. During normal aging, the gradual loss of telomeric DNA in dividing somatic cells can contribute to replicative senescence, apoptosis, or neoplastic transformation. In addition, high levels of oxidative stress have been shown to lead to reduction of telomere length. Interindividual variability in humans is high, with telomere lengths shown to vary widely even among individuals of the same age. There is evidence that telomere length is a heritable characteristic, as well as related to cardiovascular stressors or psychological stress. Thus, differences in leukocyte telomere length, even among individuals of the same chronological age, may be a marker for rate of biological aging, may be related to familial differences in longevity, and may be related to risk for mortality. The association of telomere length with mortality might also represent an effect of other processes that cause both accelerated telomere shortening and mortality, for example, increased numbers of cell divisions due to stress, in the form of infections, exposure to other deleterious environmental agents or cardiovascular risk factors, and psychological stressors.

Parçada telomer uzunluğuyla ilgili olarak aşağıdakilerden hangisi söylenmemiştir?

• Aynı yaştaki bireyler arasında bile farklılık gösterebilir.
• İnsan yaşamındaki etkisi yüksek oranlarda değişkenlik gösterir.
• Kardiyovasküler stres faktörleriyle ilişkilidir.
• Psikolojik stres ile ilişki gösterir.
• Kalıtımsal bir özelliktir.

Telomeres are short, repeated sequences of TTAGGG at the end of human chromosomes that shorten with each cell replication unless repaired by telomerase, an enzyme with some presence in cells such as lymphocytes and germ line cells. Reduction in telomere length may be an indicator of cellular aging. During normal aging, the gradual loss of telomeric DNA in dividing somatic cells can contribute to replicative senescence, apoptosis, or neoplastic transformation. In addition, high levels of oxidative stress have been shown to lead to reduction of telomere length. Interindividual variability in humans is high, with telomere lengths shown to vary widely even among individuals of the same age. There is evidence that telomere length is a heritable characteristic, as well as related to cardiovascular stressors or psychological stress. Thus, differences in leukocyte telomere length, even among individuals of the same chronological age, may be a marker for rate of biological aging, may be related to familial differences in longevity, and may be related to risk for mortality. The association of telomere length with mortality might also represent an effect of other processes that cause both accelerated telomere shortening and mortality, for example, increased numbers of cell divisions due to stress, in the form of infections, exposure to other deleterious environmental agents or cardiovascular risk factors, and psychological stressors.

Parçaya göre, lökosit telomer uzunluk farkları, aynı yaştaki bireyler arasında bile aşağıdakilerden hangisinin belirteci olabilir?

• Biyolojik yaşlanma hızı
• Aile bireyleri arasındaki farklı özellikler
• Kardiyovasküler hastalık nedenleri
• Enfeksiyonlara yatkınlık
• Çevresel faktörlerden etkilenme derecesi

Telomeres are short, repeated sequences of TTAGGG at the end of human chromosomes that shorten with each cell replication unless repaired by telomerase, an enzyme with some presence in cells such as lymphocytes and germ line cells. Reduction in telomere length may be an indicator of cellular aging. During normal aging, the gradual loss of telomeric DNA in dividing somatic cells can contribute to replicative senescence, apoptosis, or neoplastic transformation. In addition, high levels of oxidative stress have been shown to lead to reduction of telomere length. Interindividual variability in humans is high, with telomere lengths shown to vary widely even among individuals of the same age. There is evidence that telomere length is a heritable characteristic, as well as related to cardiovascular stressors or psychological stress. Thus, differences in leukocyte telomere length, even among individuals of the same chronological age, may be a marker for rate of biological aging, may be related to familial differences in longevity, and may be related to risk for mortality. The association of telomere length with mortality might also represent an effect of other processes that cause both accelerated telomere shortening and mortality, for example, increased numbers of cell divisions due to stress, in the form of infections, exposure to other deleterious environmental agents or cardiovascular risk factors, and psychological stressors.

Parçada, hücre bölünmesi sayısında artışa yol açan stres durumları arasında aşağıdakilerden hangisi sayılmamıştır?

• Zararlı çevresel ajanlar
• Enfeksiyonlar
• Kardiyovasküler risk faktörleri
• Kalıtımla geçen hastalıklar
• Psikolojik stres faktörleri

Physiologic and behavioural data indicate that hot flushes result from a defect in central thermoregulatory function. The 2 major physiologic changes associated with hot flushes – perspiration and cutaneous vasodilatation – are the result of different peripherial sympathetic functions. Excitation of sweat glands results from sympathetic cholinergic fibres, and cutaneous vasodilatation is under the control of tonic alpha-adrenergic fibres. It seems unlikely that any peripherial event could cause both cholinergic excitation of sweat glands and alphaadrenergic blockade of cutaneous vessels, and it is well recognized that these are the two basic functions triggered by central thermoregulatory mechanisms that lower the central temperature. During a hot flush, the central temperature decreases because of cutaneous vasodilatation and perspiration. If hot flushes were the result of some peripherial event, the body’s regulatory mechanisms would be expected to prevent such a decrease. There is also a change in behaviour associated with hot flushes. Women feel warm and have a conscious desire to cool themselves by throwing off the bedcovers, standing by open windows or doors, fanning themselves, or by other means. This behaviour is observed even in the presence of a steady or decreasing central temperature.

Parçada aşağıdakilerden hangisi sıcak basmasıyla ortaya çıkan değişiklikler arasında sayılmamıştır?

• Terleme
• Cilt damarlarında genişleme
• Beden sıcaklığında düşme
• Davranışlarda farklılık
• Kollarda kızarma

Physiologic and behavioural data indicate that hot flushes result from a defect in central thermoregulatory function. The 2 major physiologic changes associated with hot flushes – perspiration and cutaneous vasodilatation – are the result of different peripherial sympathetic functions. Excitation of sweat glands results from sympathetic cholinergic fibres, and cutaneous vasodilatation is under the control of tonic alpha-adrenergic fibres. It seems unlikely that any peripherial event could cause both cholinergic excitation of sweat glands and alphaadrenergic blockade of cutaneous vessels, and it is well recognized that these are the two basic functions triggered by central thermoregulatory mechanisms that lower the central temperature. During a hot flush, the central temperature decreases because of cutaneous vasodilatation and perspiration. If hot flushes were the result of some peripherial event, the body’s regulatory mechanisms would be expected to prevent such a decrease. There is also a change in behaviour associated with hot flushes. Women feel warm and have a conscious desire to cool themselves by throwing off the bedcovers, standing by open windows or doors, fanning themselves, or by other means. This behaviour is observed even in the presence of a steady or decreasing central temperature.

Parçaya göre, vazodilatasyon aşağıdakilerden hangisinin uyarılması sonucu ortaya çıkar?

• Isı düzenleme işlev merkezinin
• Alfa-adrenerjik sinir liflerinin
• Beta-adrenerjik sinir liflerinin
• Santral sinir sisteminin
• Alfa-kolinerjik sinir liflerinin

Physiologic and behavioural data indicate that hot flushes result from a defect in central thermoregulatory function. The 2 major physiologic changes associated with hot flushes – perspiration and cutaneous vasodilatation – are the result of different peripherial sympathetic functions. Excitation of sweat glands results from sympathetic cholinergic fibres, and cutaneous vasodilatation is under the control of tonic alpha-adrenergic fibres. It seems unlikely that any peripherial event could cause both cholinergic excitation of sweat glands and alphaadrenergic blockade of cutaneous vessels, and it is well recognized that these are the two basic functions triggered by central thermoregulatory mechanisms that lower the central temperature. During a hot flush, the central temperature decreases because of cutaneous vasodilatation and perspiration. If hot flushes were the result of some peripherial event, the body’s regulatory mechanisms would be expected to prevent such a decrease. There is also a change in behaviour associated with hot flushes. Women feel warm and have a conscious desire to cool themselves by throwing off the bedcovers, standing by open windows or doors, fanning themselves, or by other means. This behaviour is observed even in the presence of a steady or decreasing central temperature.

Parçaya göre, herhangi bir periferal olayın aşağı- daki hangi iki temel işleve birden yol açması olanaksız görünmektedir?

• Kolinerjik uyarı ile alfa-adrenerjik blokaj
• Sempatik sinir sistemi uyarısı ile santral sinir sistemi uyarısı
• Sempatik sinir lifi uyarısı ile parasempatik sinir lifi uyarısı
• Antikolinerjik uyarı ile alfa-adrenerjik blokaj
• Parasempatik sinir sistemi uyarısı ile santral sinir sistemi uyarısı

Physiologic and behavioural data indicate that hot flushes result from a defect in central thermoregulatory function. The 2 major physiologic changes associated with hot flushes – perspiration and cutaneous vasodilatation – are the result of different peripherial sympathetic functions. Excitation of sweat glands results from sympathetic cholinergic fibres, and cutaneous vasodilatation is under the control of tonic alpha-adrenergic fibres. It seems unlikely that any peripherial event could cause both cholinergic excitation of sweat glands and alphaadrenergic blockade of cutaneous vessels, and it is well recognized that these are the two basic functions triggered by central thermoregulatory mechanisms that lower the central temperature. During a hot flush, the central temperature decreases because of cutaneous vasodilatation and perspiration. If hot flushes were the result of some peripherial event, the body’s regulatory mechanisms would be expected to prevent such a decrease. There is also a change in behaviour associated with hot flushes. Women feel warm and have a conscious desire to cool themselves by throwing off the bedcovers, standing by open windows or doors, fanning themselves, or by other means. This behaviour is observed even in the presence of a steady or decreasing central temperature.

Parçaya göre, sıcak basmalarının bazı periferal olaylar sonucunda olması halinde aşağıdakilerden hangisinin önlenmesi beklenirdi?

• Üşümenin
• Merkezi ısı düşmesinin
• Davranış bozukluğunun
• Soğuk terlemenin
• Sinirliliğin

Physiologic and behavioural data indicate that hot flushes result from a defect in central thermoregulatory function. The 2 major physiologic changes associated with hot flushes – perspiration and cutaneous vasodilatation – are the result of different peripherial sympathetic functions. Excitation of sweat glands results from sympathetic cholinergic fibres, and cutaneous vasodilatation is under the control of tonic alpha-adrenergic fibres. It seems unlikely that any peripherial event could cause both cholinergic excitation of sweat glands and alphaadrenergic blockade of cutaneous vessels, and it is well recognized that these are the two basic functions triggered by central thermoregulatory mechanisms that lower the central temperature. During a hot flush, the central temperature decreases because of cutaneous vasodilatation and perspiration. If hot flushes were the result of some peripherial event, the body’s regulatory mechanisms would be expected to prevent such a decrease. There is also a change in behaviour associated with hot flushes. Women feel warm and have a conscious desire to cool themselves by throwing off the bedcovers, standing by open windows or doors, fanning themselves, or by other means. This behaviour is observed even in the presence of a steady or decreasing central temperature.

Parçaya göre, kadınlar kendilerini sıcak hissettikleri için, aşağıdaki durumların hangisinde bile bilinçli olarak kendilerini serinletmeye çalışırlar?

• Soğuk terleme
• Üşüme
• Ciltte kızarma
• Beden sıcaklığında düşme
• Titreme

Rheumatic fever is an autoimmune disease in which the heart valves are likely to be damaged or destroyed. It is usually initiated by streptococcal toxin in the following manner. The sequence of events almost always begins with a preliminary streptococcal infection caused specifically by group A hemolytic streptococci, such as a sore throat, scarlet fever or middle ear infection. The streptococci release several different proteins against which antibodies are formed, the most important of which seems to be a protein called the “M” antigen. The antibodies then react not only with this M antigen but also against many different tissues of the body often causing severe immunological damage. Rheumatic fever causes damage in many parts of the body but especially in certain susceptible areas, such as the heart valves. The degree of heart valve damage is directly correlated with the titer and the persistence of these antibodies. In rheumatic fever, large haemorrhagic, fibrinous, bulbous lesions grow along the inflamed edges of the heart valves. Because the mitral valve receives more trauma during valvular action than any of the other valves, it is the one most often seriously damaged, and the aortic valve is second most frequently damaged. The right heart valves, the tricuspid and pulmonary valves are usually affected much less severely, probably because the stresses that act on these valves are slight compared with those that act on the left heart valves.

Parçada, sözü edilen olaylar dizisinin başlamasıyla ilişkili olan durumlar arasında aşağıdakilerden hangisi sayılmamıştır?

• Kanama
• Kızıl
• Orta kulak iltihabı
• Boğaz ağrısı
• Grup A hemolitik streptokok enfeksiyonu

Rheumatic fever is an autoimmune disease in which the heart valves are likely to be damaged or destroyed. It is usually initiated by streptococcal toxin in the following manner. The sequence of events almost always begins with a preliminary streptococcal infection caused specifically by group A hemolytic streptococci, such as a sore throat, scarlet fever or middle ear infection. The streptococci release several different proteins against which antibodies are formed, the most important of which seems to be a protein called the “M” antigen. The antibodies then react not only with this M antigen but also against many different tissues of the body often causing severe immunological damage. Rheumatic fever causes damage in many parts of the body but especially in certain susceptible areas, such as the heart valves. The degree of heart valve damage is directly correlated with the titer and the persistence of these antibodies. In rheumatic fever, large haemorrhagic, fibrinous, bulbous lesions grow along the inflamed edges of the heart valves. Because the mitral valve receives more trauma during valvular action than any of the other valves, it is the one most often seriously damaged, and the aortic valve is second most frequently damaged. The right heart valves, the tricuspid and pulmonary valves are usually affected much less severely, probably because the stresses that act on these valves are slight compared with those that act on the left heart valves.

Parçaya göre, M antijenine karşı oluşan antikorlar aşağıdakilerden hangisine sıklıkla neden olmaktadır?

• Dolaşım bozukluğuna
• Şiddetli immünolojik hasara
• Yüksek ateşli hastalığa
• Aşırı protein kaybına
• Toksin birikimine

Rheumatic fever is an autoimmune disease in which the heart valves are likely to be damaged or destroyed. It is usually initiated by streptococcal toxin in the following manner. The sequence of events almost always begins with a preliminary streptococcal infection caused specifically by group A hemolytic streptococci, such as a sore throat, scarlet fever or middle ear infection. The streptococci release several different proteins against which antibodies are formed, the most important of which seems to be a protein called the “M” antigen. The antibodies then react not only with this M antigen but also against many different tissues of the body often causing severe immunological damage. Rheumatic fever causes damage in many parts of the body but especially in certain susceptible areas, such as the heart valves. The degree of heart valve damage is directly correlated with the titer and the persistence of these antibodies. In rheumatic fever, large haemorrhagic, fibrinous, bulbous lesions grow along the inflamed edges of the heart valves. Because the mitral valve receives more trauma during valvular action than any of the other valves, it is the one most often seriously damaged, and the aortic valve is second most frequently damaged. The right heart valves, the tricuspid and pulmonary valves are usually affected much less severely, probably because the stresses that act on these valves are slight compared with those that act on the left heart valves.

Parçaya göre, aşağıdakilerden hangisi antikorların kandaki miktarı ve kalış süresine doğrudan bağlıdır?

• Damar çeperindeki değişimler
• Romatizmal ateşin şiddeti
• Kalp kapakçığı hasarının derecesi
• Bağışıklık sisteminin uyarılması
• Kulak zarındaki yıpranma düzeyi

Rheumatic fever is an autoimmune disease in which the heart valves are likely to be damaged or destroyed. It is usually initiated by streptococcal toxin in the following manner. The sequence of events almost always begins with a preliminary streptococcal infection caused specifically by group A hemolytic streptococci, such as a sore throat, scarlet fever or middle ear infection. The streptococci release several different proteins against which antibodies are formed, the most important of which seems to be a protein called the “M” antigen. The antibodies then react not only with this M antigen but also against many different tissues of the body often causing severe immunological damage. Rheumatic fever causes damage in many parts of the body but especially in certain susceptible areas, such as the heart valves. The degree of heart valve damage is directly correlated with the titer and the persistence of these antibodies. In rheumatic fever, large haemorrhagic, fibrinous, bulbous lesions grow along the inflamed edges of the heart valves. Because the mitral valve receives more trauma during valvular action than any of the other valves, it is the one most often seriously damaged, and the aortic valve is second most frequently damaged. The right heart valves, the tricuspid and pulmonary valves are usually affected much less severely, probably because the stresses that act on these valves are slight compared with those that act on the left heart valves.

Parçada aşağıdakilerden hangisinin şiddetli hasar oluşumu sıklığında ikinci sırada olduğu söylenmektedir?

• Aort çeperi
• Mitral kapakçık
• Triküspit kapakçık
• Pulmoner kapakçık
• Aort kapakçığı

Rheumatic fever is an autoimmune disease in which the heart valves are likely to be damaged or destroyed. It is usually initiated by streptococcal toxin in the following manner. The sequence of events almost always begins with a preliminary streptococcal infection caused specifically by group A hemolytic streptococci, such as a sore throat, scarlet fever or middle ear infection. The streptococci release several different proteins against which antibodies are formed, the most important of which seems to be a protein called the “M” antigen. The antibodies then react not only with this M antigen but also against many different tissues of the body often causing severe immunological damage. Rheumatic fever causes damage in many parts of the body but especially in certain susceptible areas, such as the heart valves. The degree of heart valve damage is directly correlated with the titer and the persistence of these antibodies. In rheumatic fever, large haemorrhagic, fibrinous, bulbous lesions grow along the inflamed edges of the heart valves. Because the mitral valve receives more trauma during valvular action than any of the other valves, it is the one most often seriously damaged, and the aortic valve is second most frequently damaged. The right heart valves, the tricuspid and pulmonary valves are usually affected much less severely, probably because the stresses that act on these valves are slight compared with those that act on the left heart valves.

Parçanın son cümlesinde geçen "probably" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Muhtemelen
• Benzer şekilde
• Sonuçta
• Genellikle
• Belli ölçüde

Corticosteroids are the pharmacologic agents most often associated with cell-mediated immunity (CMI) abnormalities, although they also may cause immune suppression due to effects on other host defense mechanisms. The degree of immunosuppression and the relative risk of infection depend on the dose and duration of corticosteroids as well as the underlying disease. Patients receiving pharmacologic doses of steroids (e.g., brain tumour patients, those with inflammatory bowel disease, and with autoimmune disorders) may have impaired CMI and should be considered at risk for mycobacterial, viral and parasitic infections. Patients to be treated with corticosteroids with a known history of tuberculosis or a positive PPD skin test should be given prophylactic isoniazid (INH) to prevent reactivation and potential dissemination of disease. Cyclosporine is an immunosuppressant used to suppress transplant rejection and is associated with alterations in helper T cells, effector T cells and natural killer (NK) cells. It has not been established, however, that cyclosporine per se is associated with an increased risk of infection. Radiotherapy also may result in impaired CMI, especially when used in combination with other immunosuppressive agents or to treat patients with underlying diseases associated with intrinsic CMI defects (e.g., as a component of the preparatory regimen for bone marrow transplantation or for treatment of Hodgkin’s disesase).

Parçada kortikosteroidler özellikle hangi yönden ele alınmıştır?

• Enfeksiyonlara etkisi
• Tüberkülozda kullanımı
• Onkolojik ilaçlarla ilişkisi
• Bağışıklığı baskılayıcı etkisi
• Tümörlerle etkileşimi

Corticosteroids are the pharmacologic agents most often associated with cell-mediated immunity (CMI) abnormalities, although they also may cause immune suppression due to effects on other host defense mechanisms. The degree of immunosuppression and the relative risk of infection depend on the dose and duration of corticosteroids as well as the underlying disease. Patients receiving pharmacologic doses of steroids (e.g., brain tumour patients, those with inflammatory bowel disease, and with autoimmune disorders) may have impaired CMI and should be considered at risk for mycobacterial, viral and parasitic infections. Patients to be treated with corticosteroids with a known history of tuberculosis or a positive PPD skin test should be given prophylactic isoniazid (INH) to prevent reactivation and potential dissemination of disease. Cyclosporine is an immunosuppressant used to suppress transplant rejection and is associated with alterations in helper T cells, effector T cells and natural killer (NK) cells. It has not been established, however, that cyclosporine per se is associated with an increased risk of infection. Radiotherapy also may result in impaired CMI, especially when used in combination with other immunosuppressive agents or to treat patients with underlying diseases associated with intrinsic CMI defects (e.g., as a component of the preparatory regimen for bone marrow transplantation or for treatment of Hodgkin’s disesase).

Parçaya göre, steroid alan beyin tümörlü hastalar aşağıdakilerden hangisi için risk taşırlar?

• Metastaz
• Enfeksiyonlar
• Kanama
• Ateş
• Habisleşme

Corticosteroids are the pharmacologic agents most often associated with cell-mediated immunity (CMI) abnormalities, although they also may cause immune suppression due to effects on other host defense mechanisms. The degree of immunosuppression and the relative risk of infection depend on the dose and duration of corticosteroids as well as the underlying disease. Patients receiving pharmacologic doses of steroids (e.g., brain tumour patients, those with inflammatory bowel disease, and with autoimmune disorders) may have impaired CMI and should be considered at risk for mycobacterial, viral and parasitic infections. Patients to be treated with corticosteroids with a known history of tuberculosis or a positive PPD skin test should be given prophylactic isoniazid (INH) to prevent reactivation and potential dissemination of disease. Cyclosporine is an immunosuppressant used to suppress transplant rejection and is associated with alterations in helper T cells, effector T cells and natural killer (NK) cells. It has not been established, however, that cyclosporine per se is associated with an increased risk of infection. Radiotherapy also may result in impaired CMI, especially when used in combination with other immunosuppressive agents or to treat patients with underlying diseases associated with intrinsic CMI defects (e.g., as a component of the preparatory regimen for bone marrow transplantation or for treatment of Hodgkin’s disesase).

Parçada aşağıdakilerden hangisinin kesin olarak saptanmadığı söylenmektedir?

• Radyoterapinin immünsüpresyon tedavisinde kullanılmaması gerektiği
• Radyoterapinin kemik iliği naklinde immün sistemi baskılamadığı
• Parazit enfeksiyonlarında kortikosteroid kullanımının yararlı olduğu
• Effektor T hücrelerin doku reddini önlemek için baskılanması gerektiği
• Siklosporinin enfeksiyon riski artışıyla ilişkili olduğu

Corticosteroids are the pharmacologic agents most often associated with cell-mediated immunity (CMI) abnormalities, although they also may cause immune suppression due to effects on other host defense mechanisms. The degree of immunosuppression and the relative risk of infection depend on the dose and duration of corticosteroids as well as the underlying disease. Patients receiving pharmacologic doses of steroids (e.g., brain tumour patients, those with inflammatory bowel disease, and with autoimmune disorders) may have impaired CMI and should be considered at risk for mycobacterial, viral and parasitic infections. Patients to be treated with corticosteroids with a known history of tuberculosis or a positive PPD skin test should be given prophylactic isoniazid (INH) to prevent reactivation and potential dissemination of disease. Cyclosporine is an immunosuppressant used to suppress transplant rejection and is associated with alterations in helper T cells, effector T cells and natural killer (NK) cells. It has not been established, however, that cyclosporine per se is associated with an increased risk of infection. Radiotherapy also may result in impaired CMI, especially when used in combination with other immunosuppressive agents or to treat patients with underlying diseases associated with intrinsic CMI defects (e.g., as a component of the preparatory regimen for bone marrow transplantation or for treatment of Hodgkin’s disesase).

Parçada aşağıdakilerden hangisinin kullanımının Hodgkin hastalarının tedavisinde sorun yaratabileceğinden söz edilmiştir?

• Radyoterapi
• İmmünsüpresörler
• Vitaminler
• Antibiyotikler
• Fototerapi

Corticosteroids are the pharmacologic agents most often associated with cell-mediated immunity (CMI) abnormalities, although they also may cause immune suppression due to effects on other host defense mechanisms. The degree of immunosuppression and the relative risk of infection depend on the dose and duration of corticosteroids as well as the underlying disease. Patients receiving pharmacologic doses of steroids (e.g., brain tumour patients, those with inflammatory bowel disease, and with autoimmune disorders) may have impaired CMI and should be considered at risk for mycobacterial, viral and parasitic infections. Patients to be treated with corticosteroids with a known history of tuberculosis or a positive PPD skin test should be given prophylactic isoniazid (INH) to prevent reactivation and potential dissemination of disease. Cyclosporine is an immunosuppressant used to suppress transplant rejection and is associated with alterations in helper T cells, effector T cells and natural killer (NK) cells. It has not been established, however, that cyclosporine per se is associated with an increased risk of infection. Radiotherapy also may result in impaired CMI, especially when used in combination with other immunosuppressive agents or to treat patients with underlying diseases associated with intrinsic CMI defects (e.g., as a component of the preparatory regimen for bone marrow transplantation or for treatment of Hodgkin’s disesase).

Parçanın ilk cümlesinde geçen "due to" ifadesinin Türkçe karşılığı aşağıdakilerden hangisidir?

• Ek olarak
• Dışında
• Nedeniyle
• Rağmen
• Kısmen

The anterior pituitary is often referred to as the “master gland” because, together with the hypothalamus, it orchestrates the complex regulatory functions of multiple other endocrine glands. Pituitary hormones are secreted in a pulsatile manner, reflecting stimulation by an array of specific hypothalamic releasing factors. Each of these pituitary hormones elicits specific responses in peripheral target tissues. The hormonal products of these peripheral glands, in turn, exert feedback control at the level of the hypothalamus and pituitary to modulate pituitary function. Pituitary tumours cause characteristic hormone excess syndromes. Hormone deficiency may be inherited or acquired. Fortunately, efficacious treatments exist for the various pituitary hormone excess and deficiency syndromes. Nonetheless, these diagnoses are often misleading, emphasizing the importance of recognizing subtle clinical manifestations and performing the correct laboratory diagnostic tests.

Parçaya göre, hipofiz hormonlarının pulslu biçimde salgılanması aşağıdakilerden hangisini yansıtmaktadır?

• Ön pitüiter bezin yapısını
• Zamanlamanın önemini
• Hedef dokuların etkisini
• Hipotalamusun uyarıcı etkisini
• Diğer endokrin bezlerin birbirleriyle etkileşimini

The anterior pituitary is often referred to as the “master gland” because, together with the hypothalamus, it orchestrates the complex regulatory functions of multiple other endocrine glands. Pituitary hormones are secreted in a pulsatile manner, reflecting stimulation by an array of specific hypothalamic releasing factors. Each of these pituitary hormones elicits specific responses in peripheral target tissues. The hormonal products of these peripheral glands, in turn, exert feedback control at the level of the hypothalamus and pituitary to modulate pituitary function. Pituitary tumours cause characteristic hormone excess syndromes. Hormone deficiency may be inherited or acquired. Fortunately, efficacious treatments exist for the various pituitary hormone excess and deficiency syndromes. Nonetheless, these diagnoses are often misleading, emphasizing the importance of recognizing subtle clinical manifestations and performing the correct laboratory diagnostic tests.

Parçada hormon eksikliğiyle ilgili olarak aşağıdakilerden hangisi söylenmektedir?

• Organları şiddetle etkiler.
• Oldukça geniş etkilidir.
• Kalıtsal veya kazanılmış olabilir.
• Belirtileri uzun süre gizli kalır.
• Laboratuvar testleri ile kolayca saptanabilir.

The anterior pituitary is often referred to as the “master gland” because, together with the hypothalamus, it orchestrates the complex regulatory functions of multiple other endocrine glands. Pituitary hormones are secreted in a pulsatile manner, reflecting stimulation by an array of specific hypothalamic releasing factors. Each of these pituitary hormones elicits specific responses in peripheral target tissues. The hormonal products of these peripheral glands, in turn, exert feedback control at the level of the hypothalamus and pituitary to modulate pituitary function. Pituitary tumours cause characteristic hormone excess syndromes. Hormone deficiency may be inherited or acquired. Fortunately, efficacious treatments exist for the various pituitary hormone excess and deficiency syndromes. Nonetheless, these diagnoses are often misleading, emphasizing the importance of recognizing subtle clinical manifestations and performing the correct laboratory diagnostic tests.

Parçada şans olarak nitelenen durum aşağıdakilerden hangisidir?

• Tanının kolay olması
• Etkili tedavilerin var olması
• Hastalığın nadir görülmesi
• Belirtilerin güçlü olması
• Geri dönüşün mümkün olması

The anterior pituitary is often referred to as the “master gland” because, together with the hypothalamus, it orchestrates the complex regulatory functions of multiple other endocrine glands. Pituitary hormones are secreted in a pulsatile manner, reflecting stimulation by an array of specific hypothalamic releasing factors. Each of these pituitary hormones elicits specific responses in peripheral target tissues. The hormonal products of these peripheral glands, in turn, exert feedback control at the level of the hypothalamus and pituitary to modulate pituitary function. Pituitary tumours cause characteristic hormone excess syndromes. Hormone deficiency may be inherited or acquired. Fortunately, efficacious treatments exist for the various pituitary hormone excess and deficiency syndromes. Nonetheless, these diagnoses are often misleading, emphasizing the importance of recognizing subtle clinical manifestations and performing the correct laboratory diagnostic tests.

Parçada tanıların sıklıkla nasıl olduğundan söz edilmektedir?

• Yanıltıcı
• Kesin
• Eleyici
• Çabuk
• Farklı

The anterior pituitary is often referred to as the “master gland” because, together with the hypothalamus, it orchestrates the complex regulatory functions of multiple other endocrine glands. Pituitary hormones are secreted in a pulsatile manner, reflecting stimulation by an array of specific hypothalamic releasing factors. Each of these pituitary hormones elicits specific responses in peripheral target tissues. The hormonal products of these peripheral glands, in turn, exert feedback control at the level of the hypothalamus and pituitary to modulate pituitary function. Pituitary tumours cause characteristic hormone excess syndromes. Hormone deficiency may be inherited or acquired. Fortunately, efficacious treatments exist for the various pituitary hormone excess and deficiency syndromes. Nonetheless, these diagnoses are often misleading, emphasizing the importance of recognizing subtle clinical manifestations and performing the correct laboratory diagnostic tests.

Parçanın son cümlesinde geçen "subtle" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Rastlantısal
• Oldukça başarılı
• Bağımsız
• Az belirgin
• Güvenilir

Epidemiologic surveys of depression in patients with cancer show a wide variability in prevalence, as might be predicted by differences in tumour site, severity of illness, and type of medical or surgical intervention. There is an overall mean prevalence of 25%, but depression occurs in 40 to 50% of patients with cancers of the pancreas or oropharynx. Assessment of the validity of prevalence rates is complicated by the fact that extreme cachexia may be misinterpreted as part of the symptom complex of depression. The higher prevalence of depression in patients with pancreatic cancer nevertheless persists when patients are compared to those with advanced gastric cancer. Initiation of antidepressant medication in cancer patients has been shown to improve quality of life as well as mood. Psychotherapeutic approaches, particularly group therapy, may have some effect on short-term depression, anxiety, and pain symptoms and on recurrence rates and longterm survival. In a study of female patients with metastatic breast cancer, patients in group therapy had longer survival than control patients.

Parçada, kanser hastalarında depresyon görülme sıklığının büyük ölçüde değişkenlik göstermesinin aşağıdakilerden hangisiyle ilişkili olduğundan söz edilmemektedir?

• Uygulanan cerrahi girişim
• Hastalığın şiddeti
• Tümörün olduğu bölge
• Uygulanan tıbbi tedavi
• Hastaların cinsiyeti

Epidemiologic surveys of depression in patients with cancer show a wide variability in prevalence, as might be predicted by differences in tumour site, severity of illness, and type of medical or surgical intervention. There is an overall mean prevalence of 25%, but depression occurs in 40 to 50% of patients with cancers of the pancreas or oropharynx. Assessment of the validity of prevalence rates is complicated by the fact that extreme cachexia may be misinterpreted as part of the symptom complex of depression. The higher prevalence of depression in patients with pancreatic cancer nevertheless persists when patients are compared to those with advanced gastric cancer. Initiation of antidepressant medication in cancer patients has been shown to improve quality of life as well as mood. Psychotherapeutic approaches, particularly group therapy, may have some effect on short-term depression, anxiety, and pain symptoms and on recurrence rates and longterm survival. In a study of female patients with metastatic breast cancer, patients in group therapy had longer survival than control patients.

Parçada pankreas kanseri olan kişiler depresyon yönünden hangi tip kanserle karşılaştırılmaktadır?

• Mide
• Meme
• Akciğer
• Orofarinks
• Yemek borusu

Epidemiologic surveys of depression in patients with cancer show a wide variability in prevalence, as might be predicted by differences in tumour site, severity of illness, and type of medical or surgical intervention. There is an overall mean prevalence of 25%, but depression occurs in 40 to 50% of patients with cancers of the pancreas or oropharynx. Assessment of the validity of prevalence rates is complicated by the fact that extreme cachexia may be misinterpreted as part of the symptom complex of depression. The higher prevalence of depression in patients with pancreatic cancer nevertheless persists when patients are compared to those with advanced gastric cancer. Initiation of antidepressant medication in cancer patients has been shown to improve quality of life as well as mood. Psychotherapeutic approaches, particularly group therapy, may have some effect on short-term depression, anxiety, and pain symptoms and on recurrence rates and longterm survival. In a study of female patients with metastatic breast cancer, patients in group therapy had longer survival than control patients.

Parçada, psikoterapi yaklaşımlarının etkili olduğu durumlar arasında aşağıdakilerden hangisi sayılmamıştır?

• Anksiyete
• Tekrarlanma sıklığı
• Yaşam kalitesi
• Ağrı belirtileri
• Uzun süreli sağkalım

Epidemiologic surveys of depression in patients with cancer show a wide variability in prevalence, as might be predicted by differences in tumour site, severity of illness, and type of medical or surgical intervention. There is an overall mean prevalence of 25%, but depression occurs in 40 to 50% of patients with cancers of the pancreas or oropharynx. Assessment of the validity of prevalence rates is complicated by the fact that extreme cachexia may be misinterpreted as part of the symptom complex of depression. The higher prevalence of depression in patients with pancreatic cancer nevertheless persists when patients are compared to those with advanced gastric cancer. Initiation of antidepressant medication in cancer patients has been shown to improve quality of life as well as mood. Psychotherapeutic approaches, particularly group therapy, may have some effect on short-term depression, anxiety, and pain symptoms and on recurrence rates and longterm survival. In a study of female patients with metastatic breast cancer, patients in group therapy had longer survival than control patients.

Parçada, sözü edilen çalışmada hangi hastaların sağkalım süresinin uzadığı belirtilmektedir?

• Antidepresan kullanan
• Grup tedavisi alan
• Kemoterapi süresi uzatılan
• Depresyonu olmayan
• Yaşam kalitesini yüksek tutan

Epidemiologic surveys of depression in patients with cancer show a wide variability in prevalence, as might be predicted by differences in tumour site, severity of illness, and type of medical or surgical intervention. There is an overall mean prevalence of 25%, but depression occurs in 40 to 50% of patients with cancers of the pancreas or oropharynx. Assessment of the validity of prevalence rates is complicated by the fact that extreme cachexia may be misinterpreted as part of the symptom complex of depression. The higher prevalence of depression in patients with pancreatic cancer nevertheless persists when patients are compared to those with advanced gastric cancer. Initiation of antidepressant medication in cancer patients has been shown to improve quality of life as well as mood. Psychotherapeutic approaches, particularly group therapy, may have some effect on short-term depression, anxiety, and pain symptoms and on recurrence rates and longterm survival. In a study of female patients with metastatic breast cancer, patients in group therapy had longer survival than control patients.

Parçanın üçüncü cümlesinde geçen "may be misinterpreted" ifadesinin Türkçe karşılığı aşağıdakilerden hangisidir?

• Anlaşılamayabilir
• Tümüyle açıklanamayabilir
• Gerçeği yansıtmayabilir
• Yanlış yorumlanabilir
• Belirlenemeyebilir

Acute pancreatitis is recognized as a potentially lifethreatening illness with significant morbidity and mortality rates, especially when associated with necrosis involving >50% of the gland. The development of pancreatic necrosis is associated with infection, organ failure and death. Although the exact mechanisms that trigger the inflammatory aspect of pancreatitis are not completely understood, activation of neutrophils and lymphocytes has been recognized as an important pathogenic factor. Several methods for estimating the prognosis of acute pancreatitis and its complications are in widespread clinical use today and include the Atlanta classification, Imrie and Ranson scores, the Balthazar computed tomographic scoring system, and C-reactive protein. However, these methods have little value in predicting which patients will develop pancreatic infection. Currently, guided fine needle aspiration is the only invasive means of early and accurate diagnosis of infected necrosis. As with sepsis, evidence is mounting that local production of the proinflammatory cytokines tumour necrosis factor-α, interleukin (IL)-1β, IL-6 and IL-8 may play a central role in acute pancreatitis and may mediate the systemic response with increased soluble IL-2 receptor antagonist and neopterin seen in clinical studies.

Parçada tümüyle anlaşılamadığından söz edilen tetikleyici mekanizmalar pankreatitin hangi özelliğiyle ilgilidir?

• Patojenik
• Organ yetmezliklerine yol açan
• Bağışıklıkla ilişkili
• Prognozu etkileyen
• Yangı ile ilişkili

Acute pancreatitis is recognized as a potentially lifethreatening illness with significant morbidity and mortality rates, especially when associated with necrosis involving >50% of the gland. The development of pancreatic necrosis is associated with infection, organ failure and death. Although the exact mechanisms that trigger the inflammatory aspect of pancreatitis are not completely understood, activation of neutrophils and lymphocytes has been recognized as an important pathogenic factor. Several methods for estimating the prognosis of acute pancreatitis and its complications are in widespread clinical use today and include the Atlanta classification, Imrie and Ranson scores, the Balthazar computed tomographic scoring system, and C-reactive protein. However, these methods have little value in predicting which patients will develop pancreatic infection. Currently, guided fine needle aspiration is the only invasive means of early and accurate diagnosis of infected necrosis. As with sepsis, evidence is mounting that local production of the proinflammatory cytokines tumour necrosis factor-α, interleukin (IL)-1β, IL-6 and IL-8 may play a central role in acute pancreatitis and may mediate the systemic response with increased soluble IL-2 receptor antagonist and neopterin seen in clinical studies.

Parçada sözü edilen yöntemlerin değerinin hangi açıdan az olduğu söylenmektedir?

• Sepsisi engelleme
• Pankreasın nekrotik bölümünün oranını saptama
• Pankreatite yol açan etkenleri gösterme
• Pankreatik enfeksiyon geliştirecek hastaları belirleme
• Pankreatitte prognozu öngörme

Acute pancreatitis is recognized as a potentially lifethreatening illness with significant morbidity and mortality rates, especially when associated with necrosis involving >50% of the gland. The development of pancreatic necrosis is associated with infection, organ failure and death. Although the exact mechanisms that trigger the inflammatory aspect of pancreatitis are not completely understood, activation of neutrophils and lymphocytes has been recognized as an important pathogenic factor. Several methods for estimating the prognosis of acute pancreatitis and its complications are in widespread clinical use today and include the Atlanta classification, Imrie and Ranson scores, the Balthazar computed tomographic scoring system, and C-reactive protein. However, these methods have little value in predicting which patients will develop pancreatic infection. Currently, guided fine needle aspiration is the only invasive means of early and accurate diagnosis of infected necrosis. As with sepsis, evidence is mounting that local production of the proinflammatory cytokines tumour necrosis factor-α, interleukin (IL)-1β, IL-6 and IL-8 may play a central role in acute pancreatitis and may mediate the systemic response with increased soluble IL-2 receptor antagonist and neopterin seen in clinical studies.

Parçada aşağıdakilerden hangisinin enfekte olmuş yaraların erken ve doğru tanısını sağladığından söz edilmektedir?

• İnce iğne aspirasyonu
• Tomografi
• C-reaktif protein
• Atlanta sınıflandırması
• Derecelendirme sistemleri

Acute pancreatitis is recognized as a potentially lifethreatening illness with significant morbidity and mortality rates, especially when associated with necrosis involving >50% of the gland. The development of pancreatic necrosis is associated with infection, organ failure and death. Although the exact mechanisms that trigger the inflammatory aspect of pancreatitis are not completely understood, activation of neutrophils and lymphocytes has been recognized as an important pathogenic factor. Several methods for estimating the prognosis of acute pancreatitis and its complications are in widespread clinical use today and include the Atlanta classification, Imrie and Ranson scores, the Balthazar computed tomographic scoring system, and C-reactive protein. However, these methods have little value in predicting which patients will develop pancreatic infection. Currently, guided fine needle aspiration is the only invasive means of early and accurate diagnosis of infected necrosis. As with sepsis, evidence is mounting that local production of the proinflammatory cytokines tumour necrosis factor-α, interleukin (IL)-1β, IL-6 and IL-8 may play a central role in acute pancreatitis and may mediate the systemic response with increased soluble IL-2 receptor antagonist and neopterin seen in clinical studies.

Parçada aşağıdakilerden hangisinin akut pankreatitte merkezi rolü olduğundan söz edilmektedir?

• Lenfositlerin
• IL-2 reseptör antagonistinin
• Neopterinin
• Nötrofillerin
• Yangı öncesi sitokinlerin

Acute pancreatitis is recognized as a potentially lifethreatening illness with significant morbidity and mortality rates, especially when associated with necrosis involving >50% of the gland. The development of pancreatic necrosis is associated with infection, organ failure and death. Although the exact mechanisms that trigger the inflammatory aspect of pancreatitis are not completely understood, activation of neutrophils and lymphocytes has been recognized as an important pathogenic factor. Several methods for estimating the prognosis of acute pancreatitis and its complications are in widespread clinical use today and include the Atlanta classification, Imrie and Ranson scores, the Balthazar computed tomographic scoring system, and C-reactive protein. However, these methods have little value in predicting which patients will develop pancreatic infection. Currently, guided fine needle aspiration is the only invasive means of early and accurate diagnosis of infected necrosis. As with sepsis, evidence is mounting that local production of the proinflammatory cytokines tumour necrosis factor-α, interleukin (IL)-1β, IL-6 and IL-8 may play a central role in acute pancreatitis and may mediate the systemic response with increased soluble IL-2 receptor antagonist and neopterin seen in clinical studies.

Parçanın son cümlesinde geçen "evidence is mounting" ifadesinin Türkçe karşılığı aşağıdakilerden hangisidir?

• Nedenler ortaya çıkıyor
• Bulgular belirmeye başlıyor
• Kanıtlar artıyor
• Belirtiler saptanıyor
• Etkenler belirginleşiyor

Streptococci are gram-positive globular or coccoid bacteria that grow in chains. Streptococci colonize the mucous membranes of animals, produce catalase, and may be aerobic, anaerobic or facultative. Streptococci require complex media containing blood products for optimal growth. On blood agar plates, streptococci may cause complete (β), incomplete (α) or no hemolysis (γ). The comprehensive work of Rebecca Lancefield has allowed hemolytic streptococci to be classified into types A through O based on acid-extractable antigens of cell wall material. Availability of rapid latex agglutination kits provides even small clinical laboratories with the means to identify streptococci according to Lancefield group. Bacitracin susceptibility, bile esculin hydrolysis, and the CAMP test are useful presumptive tests for classifying groups A, D or B streptococci, respectively. Modern schemes of classification of hemolytic and nonhemolytic streptococci use complex biochemical and genetic techniques.

Parçada streptokoklar ile ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• Oksijensiz ortamda yaşayamazlar.
• Gram pozitiftirler.
• Kataloz üretirler.
• Agarda hemoliz oluşturmalarına göre üç tiptirler.
• Kan ürünleri içeren ortamlarda daha iyi ürerler.

Streptococci are gram-positive globular or coccoid bacteria that grow in chains. Streptococci colonize the mucous membranes of animals, produce catalase, and may be aerobic, anaerobic or facultative. Streptococci require complex media containing blood products for optimal growth. On blood agar plates, streptococci may cause complete (β), incomplete (α) or no hemolysis (γ). The comprehensive work of Rebecca Lancefield has allowed hemolytic streptococci to be classified into types A through O based on acid-extractable antigens of cell wall material. Availability of rapid latex agglutination kits provides even small clinical laboratories with the means to identify streptococci according to Lancefield group. Bacitracin susceptibility, bile esculin hydrolysis, and the CAMP test are useful presumptive tests for classifying groups A, D or B streptococci, respectively. Modern schemes of classification of hemolytic and nonhemolytic streptococci use complex biochemical and genetic techniques.

Parçaya göre, streptokoklar nasıl çoğalmaktadır?

• Küreler oluşturarak
• Zincir şeklinde
• Çembersel koloniler geliştirerek
• Asit üreterek
• Oksijen kullanarak

Streptococci are gram-positive globular or coccoid bacteria that grow in chains. Streptococci colonize the mucous membranes of animals, produce catalase, and may be aerobic, anaerobic or facultative. Streptococci require complex media containing blood products for optimal growth. On blood agar plates, streptococci may cause complete (β), incomplete (α) or no hemolysis (γ). The comprehensive work of Rebecca Lancefield has allowed hemolytic streptococci to be classified into types A through O based on acid-extractable antigens of cell wall material. Availability of rapid latex agglutination kits provides even small clinical laboratories with the means to identify streptococci according to Lancefield group. Bacitracin susceptibility, bile esculin hydrolysis, and the CAMP test are useful presumptive tests for classifying groups A, D or B streptococci, respectively. Modern schemes of classification of hemolytic and nonhemolytic streptococci use complex biochemical and genetic techniques.

Parçada, sözü edilen çalışma nasıl nitelendirilmektedir?

• Kapsamlı
• Farklı
• Karmaşık
• Başarılı
• Yararlı

Streptococci are gram-positive globular or coccoid bacteria that grow in chains. Streptococci colonize the mucous membranes of animals, produce catalase, and may be aerobic, anaerobic or facultative. Streptococci require complex media containing blood products for optimal growth. On blood agar plates, streptococci may cause complete (β), incomplete (α) or no hemolysis (γ). The comprehensive work of Rebecca Lancefield has allowed hemolytic streptococci to be classified into types A through O based on acid-extractable antigens of cell wall material. Availability of rapid latex agglutination kits provides even small clinical laboratories with the means to identify streptococci according to Lancefield group. Bacitracin susceptibility, bile esculin hydrolysis, and the CAMP test are useful presumptive tests for classifying groups A, D or B streptococci, respectively. Modern schemes of classification of hemolytic and nonhemolytic streptococci use complex biochemical and genetic techniques.

Parçada hemolitik streptokokların aşağıdakilerden hangisindeki antijenlerine göre sınıflandırıldıklarından söz edilmektedir?

• Ortamdaki
• Hücre zarındaki
• Salgıdaki
• Hücre duvarındaki
• Stoplazmadaki

Streptococci are gram-positive globular or coccoid bacteria that grow in chains. Streptococci colonize the mucous membranes of animals, produce catalase, and may be aerobic, anaerobic or facultative. Streptococci require complex media containing blood products for optimal growth. On blood agar plates, streptococci may cause complete (β), incomplete (α) or no hemolysis (γ). The comprehensive work of Rebecca Lancefield has allowed hemolytic streptococci to be classified into types A through O based on acid-extractable antigens of cell wall material. Availability of rapid latex agglutination kits provides even small clinical laboratories with the means to identify streptococci according to Lancefield group. Bacitracin susceptibility, bile esculin hydrolysis, and the CAMP test are useful presumptive tests for classifying groups A, D or B streptococci, respectively. Modern schemes of classification of hemolytic and nonhemolytic streptococci use complex biochemical and genetic techniques.

Parçaya göre, karmaşık biyokimyasal ve genetik teknikler streptokokların aşağıdaki hangi özelliğine göre sınıflanmasında kullanılmaktadır?

• Gram pozitif/negatif
• Aerobik/anaerobik
• Aglutine olan/olmayan
• Tip A/D/B
• Hemolitik/nonhemolitik

Genital herpes, most often caused by HSV-2, may be complicated by local or radicular pain, aseptic meningitis, autonomic (bowel, bladder and sexual) dysfunction, and, rarely, myelitis. These complications are more common in association with primary genital herpes but may occur with recurrent disease as well. Prodromal neuritic symptoms commonly precede recurrences and may involve the buttock, the groin, or, less commonly, the lower extremities. Aseptic meningitis and autonomic dysfunction may occur either independently or together. Meningitic symptoms are associated with primary genital herpes in about one fourth of patients, but only a minority require hospitalization. Its course is benign, usually clearing in 4 to 10 days without residua. The CSF profile is typical of an aseptic meningitis, with a mononuclear pleocytosis, mild protein elevation, and normal, or occasionally reduced, glucose level. When the history clearly implicates an epidemiologic and temporal relationship with genital herpes and the CSF findings are those of a typical mononuclear profile, a clinical diagnosis can usually be made. Specific diagnosis can often be established by isolation of HSV-2 at lumbar puncture. Urinary retention, constipation and sexual impotence in association with genital herpes are less common than meningitis. Symptoms and signs of a sacral sensory radiculopathy sometimes accompany the autonomic changes. The pathophysiology of this disorder is uncertain, but direct herpetic infection of nervous system structures is likely. Fortunately, autonomic dysfunction is reversible, and patients can be assured that their symptoms will probably clear.

Parçada genital herpesin aşağıdaki komplikasyonlarından hangisinin nadir olarak görüldüğü belirtilmektedir?

• Aseptik menenjit
• Miyelit
• Bölgesel ağrı
• Sempatik sistem bozukluğu
• Cinsel işlev bozukluğu

Genital herpes, most often caused by HSV-2, may be complicated by local or radicular pain, aseptic meningitis, autonomic (bowel, bladder and sexual) dysfunction, and, rarely, myelitis. These complications are more common in association with primary genital herpes but may occur with recurrent disease as well. Prodromal neuritic symptoms commonly precede recurrences and may involve the buttock, the groin, or, less commonly, the lower extremities. Aseptic meningitis and autonomic dysfunction may occur either independently or together. Meningitic symptoms are associated with primary genital herpes in about one fourth of patients, but only a minority require hospitalization. Its course is benign, usually clearing in 4 to 10 days without residua. The CSF profile is typical of an aseptic meningitis, with a mononuclear pleocytosis, mild protein elevation, and normal, or occasionally reduced, glucose level. When the history clearly implicates an epidemiologic and temporal relationship with genital herpes and the CSF findings are those of a typical mononuclear profile, a clinical diagnosis can usually be made. Specific diagnosis can often be established by isolation of HSV-2 at lumbar puncture. Urinary retention, constipation and sexual impotence in association with genital herpes are less common than meningitis. Symptoms and signs of a sacral sensory radiculopathy sometimes accompany the autonomic changes. The pathophysiology of this disorder is uncertain, but direct herpetic infection of nervous system structures is likely. Fortunately, autonomic dysfunction is reversible, and patients can be assured that their symptoms will probably clear.

Parçaya göre, primer genital herpes hastalarından ne kadarı menenjit belirtisi göstermektdir?

• Çok azı
• Yarısı
• Yüzde dördü
• Dörtte biri
• Çoğu

Genital herpes, most often caused by HSV-2, may be complicated by local or radicular pain, aseptic meningitis, autonomic (bowel, bladder and sexual) dysfunction, and, rarely, myelitis. These complications are more common in association with primary genital herpes but may occur with recurrent disease as well. Prodromal neuritic symptoms commonly precede recurrences and may involve the buttock, the groin, or, less commonly, the lower extremities. Aseptic meningitis and autonomic dysfunction may occur either independently or together. Meningitic symptoms are associated with primary genital herpes in about one fourth of patients, but only a minority require hospitalization. Its course is benign, usually clearing in 4 to 10 days without residua. The CSF profile is typical of an aseptic meningitis, with a mononuclear pleocytosis, mild protein elevation, and normal, or occasionally reduced, glucose level. When the history clearly implicates an epidemiologic and temporal relationship with genital herpes and the CSF findings are those of a typical mononuclear profile, a clinical diagnosis can usually be made. Specific diagnosis can often be established by isolation of HSV-2 at lumbar puncture. Urinary retention, constipation and sexual impotence in association with genital herpes are less common than meningitis. Symptoms and signs of a sacral sensory radiculopathy sometimes accompany the autonomic changes. The pathophysiology of this disorder is uncertain, but direct herpetic infection of nervous system structures is likely. Fortunately, autonomic dysfunction is reversible, and patients can be assured that their symptoms will probably clear.

Parçada beyin omurilik sıvısıyla ilgili aşağıdaki bulgulardan hangisinin ara sıra görüldüğünden söz edilmektedir?

• Mononükleer hücre artışı
• Protein artışı
• Glukoz azalması
• Normal glukoz düzeyi
• HSV-2

Genital herpes, most often caused by HSV-2, may be complicated by local or radicular pain, aseptic meningitis, autonomic (bowel, bladder and sexual) dysfunction, and, rarely, myelitis. These complications are more common in association with primary genital herpes but may occur with recurrent disease as well. Prodromal neuritic symptoms commonly precede recurrences and may involve the buttock, the groin, or, less commonly, the lower extremities. Aseptic meningitis and autonomic dysfunction may occur either independently or together. Meningitic symptoms are associated with primary genital herpes in about one fourth of patients, but only a minority require hospitalization. Its course is benign, usually clearing in 4 to 10 days without residua. The CSF profile is typical of an aseptic meningitis, with a mononuclear pleocytosis, mild protein elevation, and normal, or occasionally reduced, glucose level. When the history clearly implicates an epidemiologic and temporal relationship with genital herpes and the CSF findings are those of a typical mononuclear profile, a clinical diagnosis can usually be made. Specific diagnosis can often be established by isolation of HSV-2 at lumbar puncture. Urinary retention, constipation and sexual impotence in association with genital herpes are less common than meningitis. Symptoms and signs of a sacral sensory radiculopathy sometimes accompany the autonomic changes. The pathophysiology of this disorder is uncertain, but direct herpetic infection of nervous system structures is likely. Fortunately, autonomic dysfunction is reversible, and patients can be assured that their symptoms will probably clear.

Parçada hastaların hangi konuda rahat olmaları gerektiği söylenmektedir?

• Enfeksiyonların kısa süreli olduğu
• Belirtilerin büyük bir olasılıkla yok olacağı
• Herpetik lezyonların yok olacağı
• Genital herpesin sinir sistemini etkilemeyeceği
• Menenjit belirtilerinin her zaman çıkmayabileceği

Genital herpes, most often caused by HSV-2, may be complicated by local or radicular pain, aseptic meningitis, autonomic (bowel, bladder and sexual) dysfunction, and, rarely, myelitis. These complications are more common in association with primary genital herpes but may occur with recurrent disease as well. Prodromal neuritic symptoms commonly precede recurrences and may involve the buttock, the groin, or, less commonly, the lower extremities. Aseptic meningitis and autonomic dysfunction may occur either independently or together. Meningitic symptoms are associated with primary genital herpes in about one fourth of patients, but only a minority require hospitalization. Its course is benign, usually clearing in 4 to 10 days without residua. The CSF profile is typical of an aseptic meningitis, with a mononuclear pleocytosis, mild protein elevation, and normal, or occasionally reduced, glucose level. When the history clearly implicates an epidemiologic and temporal relationship with genital herpes and the CSF findings are those of a typical mononuclear profile, a clinical diagnosis can usually be made. Specific diagnosis can often be established by isolation of HSV-2 at lumbar puncture. Urinary retention, constipation and sexual impotence in association with genital herpes are less common than meningitis. Symptoms and signs of a sacral sensory radiculopathy sometimes accompany the autonomic changes. The pathophysiology of this disorder is uncertain, but direct herpetic infection of nervous system structures is likely. Fortunately, autonomic dysfunction is reversible, and patients can be assured that their symptoms will probably clear.

Parçanın sekizinci cümlesinde geçen "clearly" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Açıkça
• Kısaca
• Özellikle
• Tam olarak
• Kesin olarak

Absence of one papillary muscle for the mitral valve is rare. In patients with this condition, all of the chordae tendineae are usually inserted into a single papillary muscle, i.e., the so-called parachute mitral valve. The absence of one papillary muscle with normal positioning of the other is a different, but rare, mitral deformity. A 21-year-old woman had a ventricular septal defect (with spontaneous closure) and mitral regurgitation as a child. She was referred to hospital for detailed examination. Transthoracic and transesophageal echocardiography showed massive anterolateral mitral regurgitation. The posteromedial papillary muscle was positioned normally and controlled the posteromedial half of both leaflets. Protrusions on the anterolateral ventricular wall were not a papillary muscle and became indistinct during scanning, particularly during diastole. The corresponding half of the anterior leaflet prolapsed heavily, and no chordae were visible. Cardiac catheterization showed severe grade 4 mitral regurgitation with normal left ventricular function. Although the patient was asymptomatic, she had an operation because of the severity of regurgitation and because she hoped to become pregnant later.

Parçaya göre, aşağıdaki durumlardan hangisi "paraşüt mitral kapak" olarak adlandırılmaktadır?

• Papiller kas zayıflığı
• Korda tendinea eksikliği
• Papiller kas hipertrofisi
• Normal bağlanımlı korda tendinea fazlalığı
• Anormal bağlanımlı papiller kas eksikliği

Absence of one papillary muscle for the mitral valve is rare. In patients with this condition, all of the chordae tendineae are usually inserted into a single papillary muscle, i.e., the so-called parachute mitral valve. The absence of one papillary muscle with normal positioning of the other is a different, but rare, mitral deformity. A 21-year-old woman had a ventricular septal defect (with spontaneous closure) and mitral regurgitation as a child. She was referred to hospital for detailed examination. Transthoracic and transesophageal echocardiography showed massive anterolateral mitral regurgitation. The posteromedial papillary muscle was positioned normally and controlled the posteromedial half of both leaflets. Protrusions on the anterolateral ventricular wall were not a papillary muscle and became indistinct during scanning, particularly during diastole. The corresponding half of the anterior leaflet prolapsed heavily, and no chordae were visible. Cardiac catheterization showed severe grade 4 mitral regurgitation with normal left ventricular function. Although the patient was asymptomatic, she had an operation because of the severity of regurgitation and because she hoped to become pregnant later.

Parçada sözü edilen kadın hastanın kendiliğinden düzelmiş olan sorunu aşağıdakilerden hangisidir?

• Posteromedial papiller kasın yerleşimi
• Anterolateral mitral regürjitasyon
• Ventriküler septal defekt
• Mitral kapak yetmezliği
• Mitral kord defekti

Absence of one papillary muscle for the mitral valve is rare. In patients with this condition, all of the chordae tendineae are usually inserted into a single papillary muscle, i.e., the so-called parachute mitral valve. The absence of one papillary muscle with normal positioning of the other is a different, but rare, mitral deformity. A 21-year-old woman had a ventricular septal defect (with spontaneous closure) and mitral regurgitation as a child. She was referred to hospital for detailed examination. Transthoracic and transesophageal echocardiography showed massive anterolateral mitral regurgitation. The posteromedial papillary muscle was positioned normally and controlled the posteromedial half of both leaflets. Protrusions on the anterolateral ventricular wall were not a papillary muscle and became indistinct during scanning, particularly during diastole. The corresponding half of the anterior leaflet prolapsed heavily, and no chordae were visible. Cardiac catheterization showed severe grade 4 mitral regurgitation with normal left ventricular function. Although the patient was asymptomatic, she had an operation because of the severity of regurgitation and because she hoped to become pregnant later.

Aşağıdakilerden hangisi, parçada sözü edilen hastanın ekokardiyografisinde saptandığı belirtilen durumlardan birisidir?

• Anterolateral mitral regürjitasyon
• Anormal yerleşimli posteromedial papiller adale
• Posteromedial kontrollü papiller adale kısalığı
• Anterolateral ventriküler duvar inceliği
• Papiller adalelerde gevşeklik

Absence of one papillary muscle for the mitral valve is rare. In patients with this condition, all of the chordae tendineae are usually inserted into a single papillary muscle, i.e., the so-called parachute mitral valve. The absence of one papillary muscle with normal positioning of the other is a different, but rare, mitral deformity. A 21-year-old woman had a ventricular septal defect (with spontaneous closure) and mitral regurgitation as a child. She was referred to hospital for detailed examination. Transthoracic and transesophageal echocardiography showed massive anterolateral mitral regurgitation. The posteromedial papillary muscle was positioned normally and controlled the posteromedial half of both leaflets. Protrusions on the anterolateral ventricular wall were not a papillary muscle and became indistinct during scanning, particularly during diastole. The corresponding half of the anterior leaflet prolapsed heavily, and no chordae were visible. Cardiac catheterization showed severe grade 4 mitral regurgitation with normal left ventricular function. Although the patient was asymptomatic, she had an operation because of the severity of regurgitation and because she hoped to become pregnant later.

Parçaya göre, kardiak kateterizasyonda "normal" olarak saptanan durum aşağıdakilerden hangisidir?

• Diastolde mitral kapak hareketi
• Sol ventrikül ön duvar kalınlığı
• Ventriküler septum işlevi
• Sol ventrikül işlevi
• Sistolde mitral kapak işlevi

Absence of one papillary muscle for the mitral valve is rare. In patients with this condition, all of the chordae tendineae are usually inserted into a single papillary muscle, i.e., the so-called parachute mitral valve. The absence of one papillary muscle with normal positioning of the other is a different, but rare, mitral deformity. A 21-year-old woman had a ventricular septal defect (with spontaneous closure) and mitral regurgitation as a child. She was referred to hospital for detailed examination. Transthoracic and transesophageal echocardiography showed massive anterolateral mitral regurgitation. The posteromedial papillary muscle was positioned normally and controlled the posteromedial half of both leaflets. Protrusions on the anterolateral ventricular wall were not a papillary muscle and became indistinct during scanning, particularly during diastole. The corresponding half of the anterior leaflet prolapsed heavily, and no chordae were visible. Cardiac catheterization showed severe grade 4 mitral regurgitation with normal left ventricular function. Although the patient was asymptomatic, she had an operation because of the severity of regurgitation and because she hoped to become pregnant later.

Parçada sözü edilen hastanın ameliyata alınmasının bir nedeni aşağıdakilerden hangisidir?

• İleride belirtilerinin başlayacak olması
• Hamile kalmayı planlaması
• Ventriküler septal defektinin olması
• Genç olması
• Çocukluğundan beri kalp hastalığının olması

Coarctation of the aorta typically occurs in the area distal to the left subclavian artery near the insertion of the ligamentum arteriosum. However, researchers have observed an unusual form of coarctation of the distal thoracic aorta just above the diaphragm in an infant. The unique challenges of this complex vascular anatomy are discussed. A 6-week-old female infant underwent evaluation due to the presence of a heart murmur, hypertension, and signs of congestive failure. On examination the blood pressure in the right arm was 105/43 mm Hg and 66/23 mm Hg in the right leg. Femoral pulses were present but weak. There was a grade III/VI blowing systolic murmur of mitral regurgitation at the apex and a soft continuous murmur over the back. Echocardiography demonstrated a large patent ductus arteriosus and a discrete juxta-ductal infolding suggestive of coarctation of the aorta. A 36 mm Hg peak instantaneous pressure gradient was predicted. The distal thoracic aorta was not visualized. The abdominal aorta was fully delineated and revealed a low velocity, poorly pulsatile flow pattern.

Parçaya göre, aort koarktasyonu tipik olarak nerede meydana gelmektedir?

• İki subklaviyan arterin ortasında
• Ligamentum arteriozumun distalinde
• Sol subklaviyan arterin distalinde
• Sol karotis arterin yakınında
• Sol ventrikülerin yakınında

Coarctation of the aorta typically occurs in the area distal to the left subclavian artery near the insertion of the ligamentum arteriosum. However, researchers have observed an unusual form of coarctation of the distal thoracic aorta just above the diaphragm in an infant. The unique challenges of this complex vascular anatomy are discussed. A 6-week-old female infant underwent evaluation due to the presence of a heart murmur, hypertension, and signs of congestive failure. On examination the blood pressure in the right arm was 105/43 mm Hg and 66/23 mm Hg in the right leg. Femoral pulses were present but weak. There was a grade III/VI blowing systolic murmur of mitral regurgitation at the apex and a soft continuous murmur over the back. Echocardiography demonstrated a large patent ductus arteriosus and a discrete juxta-ductal infolding suggestive of coarctation of the aorta. A 36 mm Hg peak instantaneous pressure gradient was predicted. The distal thoracic aorta was not visualized. The abdominal aorta was fully delineated and revealed a low velocity, poorly pulsatile flow pattern.

Parçada sözü edilen hastanın özellikleri arasında aşağıdakilerden hangisi sayılmamıştır?

• Altı haftalıktır.
• Taşikardisi vardır.
• Cinsiyeti kızdır.
• Hipertansiyonu vardır.
• Konjestif kalp yetmezliği vardır.

Coarctation of the aorta typically occurs in the area distal to the left subclavian artery near the insertion of the ligamentum arteriosum. However, researchers have observed an unusual form of coarctation of the distal thoracic aorta just above the diaphragm in an infant. The unique challenges of this complex vascular anatomy are discussed. A 6-week-old female infant underwent evaluation due to the presence of a heart murmur, hypertension, and signs of congestive failure. On examination the blood pressure in the right arm was 105/43 mm Hg and 66/23 mm Hg in the right leg. Femoral pulses were present but weak. There was a grade III/VI blowing systolic murmur of mitral regurgitation at the apex and a soft continuous murmur over the back. Echocardiography demonstrated a large patent ductus arteriosus and a discrete juxta-ductal infolding suggestive of coarctation of the aorta. A 36 mm Hg peak instantaneous pressure gradient was predicted. The distal thoracic aorta was not visualized. The abdominal aorta was fully delineated and revealed a low velocity, poorly pulsatile flow pattern.

Parçada sözü edilen hastada yumuşak devamlı üfürümün nerede işitildiği belirtilmiştir?

• Sağ kolda
• Apekste
• Femoral arterde
• Sırtta
• Karında

Coarctation of the aorta typically occurs in the area distal to the left subclavian artery near the insertion of the ligamentum arteriosum. However, researchers have observed an unusual form of coarctation of the distal thoracic aorta just above the diaphragm in an infant. The unique challenges of this complex vascular anatomy are discussed. A 6-week-old female infant underwent evaluation due to the presence of a heart murmur, hypertension, and signs of congestive failure. On examination the blood pressure in the right arm was 105/43 mm Hg and 66/23 mm Hg in the right leg. Femoral pulses were present but weak. There was a grade III/VI blowing systolic murmur of mitral regurgitation at the apex and a soft continuous murmur over the back. Echocardiography demonstrated a large patent ductus arteriosus and a discrete juxta-ductal infolding suggestive of coarctation of the aorta. A 36 mm Hg peak instantaneous pressure gradient was predicted. The distal thoracic aorta was not visualized. The abdominal aorta was fully delineated and revealed a low velocity, poorly pulsatile flow pattern.

Parçada sözü edilen hastada aort koarktasyon düşündüren bulgu aşağıdakilerden hangisidir?

• Zayıf ama mevcut femoral nabız
• Belirsiz jukstaduktal içe katlanma ve geniş patent duktus arteriozus
• III/VI derecesinde sistolik üfürüm
• Kan basıncının sağ kolda 105/43 mmHg olması
• Kan basıncının sağ bacakta 66/23 mmHg olması

Coarctation of the aorta typically occurs in the area distal to the left subclavian artery near the insertion of the ligamentum arteriosum. However, researchers have observed an unusual form of coarctation of the distal thoracic aorta just above the diaphragm in an infant. The unique challenges of this complex vascular anatomy are discussed. A 6-week-old female infant underwent evaluation due to the presence of a heart murmur, hypertension, and signs of congestive failure. On examination the blood pressure in the right arm was 105/43 mm Hg and 66/23 mm Hg in the right leg. Femoral pulses were present but weak. There was a grade III/VI blowing systolic murmur of mitral regurgitation at the apex and a soft continuous murmur over the back. Echocardiography demonstrated a large patent ductus arteriosus and a discrete juxta-ductal infolding suggestive of coarctation of the aorta. A 36 mm Hg peak instantaneous pressure gradient was predicted. The distal thoracic aorta was not visualized. The abdominal aorta was fully delineated and revealed a low velocity, poorly pulsatile flow pattern.

Parçada sözü edilen hastanın ekokardiyografisinde görülmediği belirtilen bulgu aşağıdakilerden hangisidir?

• Distal torasik aorta
• Abdominal aorta
• Patent duktus arteriozus
• Mitral yetmezlik
• Ventriküler septal defekt

Erythrasma is infection of the top layers of the skin caused by the bacterium Corynebacterium minutissimum. Erythrasma affects mostly adults, especially those with diabetes; it is rarely seen in the tropics. Erythrasma often appears in areas where skin touches skin, such as under the breasts and in the armpits, webs of the toes, and genital area – especially in men, where the thighs touch the scrotum. The infection can produce irregularly shaped pink patches that may later turn into fine brown scales. In some people, the infection spreads to the torso and anal area. Although erythrasma may be confused with a fungal infection, doctors can easily diagnose erythrasma because skin infected with Corynebacterium glows coral red under an ultraviolet light. An oral antibiotic, such as erythromycin or tetracycline, can eliminate the infection. Antibacterial soaps, such as chlorhexidine, may also help. Topical drugs such as clindamycin and miconazole cream are also effective. Erythrasma may recur in 6 to 12 months, necessitating a second treatment.

Parçaya göre, eritrazma özellikle aşağıdaki gruplardan hangisini etkilemektedir?

• Diyabetli erişkinler
• Tropikal bölgelerde yaşayanlar
• Ciltleri hassas çocuklar
• Cildinde hastalık olanlar
• Beslenme bozukluğu olan çocuklar

Erythrasma is infection of the top layers of the skin caused by the bacterium Corynebacterium minutissimum. Erythrasma affects mostly adults, especially those with diabetes; it is rarely seen in the tropics. Erythrasma often appears in areas where skin touches skin, such as under the breasts and in the armpits, webs of the toes, and genital area – especially in men, where the thighs touch the scrotum. The infection can produce irregularly shaped pink patches that may later turn into fine brown scales. In some people, the infection spreads to the torso and anal area. Although erythrasma may be confused with a fungal infection, doctors can easily diagnose erythrasma because skin infected with Corynebacterium glows coral red under an ultraviolet light. An oral antibiotic, such as erythromycin or tetracycline, can eliminate the infection. Antibacterial soaps, such as chlorhexidine, may also help. Topical drugs such as clindamycin and miconazole cream are also effective. Erythrasma may recur in 6 to 12 months, necessitating a second treatment.

Parçada eritrazmanın sık görüldüğü vücut bölgeleri arasında aşağıdakilerden hangisi sayılmamıştır?

• Ayak parmak araları
• Memelerin altı
• Koltuk altları
• Kulak arkası
• Skrotumun bacaklara değdiği yer

Erythrasma is infection of the top layers of the skin caused by the bacterium Corynebacterium minutissimum. Erythrasma affects mostly adults, especially those with diabetes; it is rarely seen in the tropics. Erythrasma often appears in areas where skin touches skin, such as under the breasts and in the armpits, webs of the toes, and genital area – especially in men, where the thighs touch the scrotum. The infection can produce irregularly shaped pink patches that may later turn into fine brown scales. In some people, the infection spreads to the torso and anal area. Although erythrasma may be confused with a fungal infection, doctors can easily diagnose erythrasma because skin infected with Corynebacterium glows coral red under an ultraviolet light. An oral antibiotic, such as erythromycin or tetracycline, can eliminate the infection. Antibacterial soaps, such as chlorhexidine, may also help. Topical drugs such as clindamycin and miconazole cream are also effective. Erythrasma may recur in 6 to 12 months, necessitating a second treatment.

Parçada eritrazmanın başlangıçta oluşturduğu lezyon nasıl tanımlanmaktadır?

• Kırmızı, düzenli
• Kahverengi, düzensiz
• Kahverengi, kabarık
• Kırmızı, çukur
• Pembe, düzensiz

Erythrasma is infection of the top layers of the skin caused by the bacterium Corynebacterium minutissimum. Erythrasma affects mostly adults, especially those with diabetes; it is rarely seen in the tropics. Erythrasma often appears in areas where skin touches skin, such as under the breasts and in the armpits, webs of the toes, and genital area – especially in men, where the thighs touch the scrotum. The infection can produce irregularly shaped pink patches that may later turn into fine brown scales. In some people, the infection spreads to the torso and anal area. Although erythrasma may be confused with a fungal infection, doctors can easily diagnose erythrasma because skin infected with Corynebacterium glows coral red under an ultraviolet light. An oral antibiotic, such as erythromycin or tetracycline, can eliminate the infection. Antibacterial soaps, such as chlorhexidine, may also help. Topical drugs such as clindamycin and miconazole cream are also effective. Erythrasma may recur in 6 to 12 months, necessitating a second treatment.

Parçada eritrazmanın ayırıcı tanısıyla ilgili olarak aşağıdakilerden hangisi söylenmektedir?

• Lokalizasyonu ile ultraviyole yanığından ayrılır.
• Viral enfeksiyonlardan ayırt etmek için ultraviyole ışığı kullanılır.
• Bakteriyel enfeksiyonlardan mercan kırmızısı rengi ile ayrılır.
• Mantar enfeksiyonlarından ayırt etmek için ultraviyole ışığı kullanılır.
• Mantar enfeksiyonlarından ayırt etmek için ultraviyole ışığı kullanılır.

Erythrasma is infection of the top layers of the skin caused by the bacterium Corynebacterium minutissimum. Erythrasma affects mostly adults, especially those with diabetes; it is rarely seen in the tropics. Erythrasma often appears in areas where skin touches skin, such as under the breasts and in the armpits, webs of the toes, and genital area – especially in men, where the thighs touch the scrotum. The infection can produce irregularly shaped pink patches that may later turn into fine brown scales. In some people, the infection spreads to the torso and anal area. Although erythrasma may be confused with a fungal infection, doctors can easily diagnose erythrasma because skin infected with Corynebacterium glows coral red under an ultraviolet light. An oral antibiotic, such as erythromycin or tetracycline, can eliminate the infection. Antibacterial soaps, such as chlorhexidine, may also help. Topical drugs such as clindamycin and miconazole cream are also effective. Erythrasma may recur in 6 to 12 months, necessitating a second treatment.

Parçada eritrazmanın tedavisiyle ilgili olarak aşağıdakilerden hangisi söylenmektedir?

• Nüks ederse tedavi değiştirilmelidir.
• Antibakteriyel sabunlar nüksü önler.
• Bölgesel ilaçlar nükse yol açar.
• Nüksü önlemek için tedaviyi 6-12 ay sürdürmek gerekir.
• Ağızdan antibiyotikler etkilidir.

Corneal storage in organ culture is the most common preservation technique in Europe. Compared with storage at +4ºC, it allows better detection of pregraft microbiological contaminations, as well extended storage time. Organ culture was originally introduced in order to extend cornea storage time to more than 10-14 days, a duration beyond which +4ºC techniques no longer ensure the viability of endothelial cells. However, owing to the high temperature involved, organ culture presents a greater risk of micro-organism development. So although it is well known that reducing storage time increases endothelial viability, corneas are not usually delivered by the banks until they have spent at least 10-12 days in organ culture, the period required to reveal any bacterial or fungal contamination using conventional bacteriological techniques and/or to observe any macroscopic changes in the storage medium. Microbiological controls are typically performed using standard bacteriological media in aerobic and anaerobic atmospheres, and Sabouraud broth. Micro-organism development is monitored by daily visual inspections of the inoculated media.

Parçaya göre, korneanın organ kültüründe saklanmasının en yaygın teknik olmasının nedeni aşağıdakilerden hangisidir?

• +4ºC’de saklanabilmesi
• Mikrop bulaşının engellenmesi
• Mikrop bulaşının saptanabilmesi
• Kısa sürede kullanılabilmesi
• Organ kültürünün kolay hazırlanabilmesi

Corneal storage in organ culture is the most common preservation technique in Europe. Compared with storage at +4ºC, it allows better detection of pregraft microbiological contaminations, as well extended storage time. Organ culture was originally introduced in order to extend cornea storage time to more than 10-14 days, a duration beyond which +4ºC techniques no longer ensure the viability of endothelial cells. However, owing to the high temperature involved, organ culture presents a greater risk of micro-organism development. So although it is well known that reducing storage time increases endothelial viability, corneas are not usually delivered by the banks until they have spent at least 10-12 days in organ culture, the period required to reveal any bacterial or fungal contamination using conventional bacteriological techniques and/or to observe any macroscopic changes in the storage medium. Microbiological controls are typically performed using standard bacteriological media in aerobic and anaerobic atmospheres, and Sabouraud broth. Micro-organism development is monitored by daily visual inspections of the inoculated media.

Parçaya göre, korneanın +4ºC’de saklanmasının dezavantajı aşağıdakilerden hangisidir?

• Ortamın yeterince soğuk olmaması
• Endotel hücrelerinin 10-14 günden daha uzun süre canlı kalamaması
• Sıcak ortamda hücrelerin hemen bozulması
• 10-14 günden daha uzun sürede mikropların harekete geçmesi
• Pratik bir yöntem olmaması

Corneal storage in organ culture is the most common preservation technique in Europe. Compared with storage at +4ºC, it allows better detection of pregraft microbiological contaminations, as well extended storage time. Organ culture was originally introduced in order to extend cornea storage time to more than 10-14 days, a duration beyond which +4ºC techniques no longer ensure the viability of endothelial cells. However, owing to the high temperature involved, organ culture presents a greater risk of micro-organism development. So although it is well known that reducing storage time increases endothelial viability, corneas are not usually delivered by the banks until they have spent at least 10-12 days in organ culture, the period required to reveal any bacterial or fungal contamination using conventional bacteriological techniques and/or to observe any macroscopic changes in the storage medium. Microbiological controls are typically performed using standard bacteriological media in aerobic and anaerobic atmospheres, and Sabouraud broth. Micro-organism development is monitored by daily visual inspections of the inoculated media.

Parçaya göre, korneanın bankalarda en az 10-12 gün geçirmesi aşağıdakilerden hangisi için gerekmektedir?

• Vericinin kesin ölüm nedeninin saptanması
• Endotelin mikroskobik incelemesinin yapılması
• Vericinin ailesinden izin alınması
• Korneanın mikrobik kontrolünün yapılması
• Uygun alıcının beklenmesi

Corneal storage in organ culture is the most common preservation technique in Europe. Compared with storage at +4ºC, it allows better detection of pregraft microbiological contaminations, as well extended storage time. Organ culture was originally introduced in order to extend cornea storage time to more than 10-14 days, a duration beyond which +4ºC techniques no longer ensure the viability of endothelial cells. However, owing to the high temperature involved, organ culture presents a greater risk of micro-organism development. So although it is well known that reducing storage time increases endothelial viability, corneas are not usually delivered by the banks until they have spent at least 10-12 days in organ culture, the period required to reveal any bacterial or fungal contamination using conventional bacteriological techniques and/or to observe any macroscopic changes in the storage medium. Microbiological controls are typically performed using standard bacteriological media in aerobic and anaerobic atmospheres, and Sabouraud broth. Micro-organism development is monitored by daily visual inspections of the inoculated media.

Parçada sözü edilen mikrobiyolojik denetimlerde kullanılan yöntemler arasında aşağıdakilerden hangisi sayılmamıştır?

• Anaerobik bakteriyolojik inceleme
• Aerobik bakteriyolojik inceleme
• Işık mikroskobisiyle günlük inceleme
• Sabouroud besiyerinde inceleme
• Kültür ortamının günlük gözlenmesi

Corneal storage in organ culture is the most common preservation technique in Europe. Compared with storage at +4ºC, it allows better detection of pregraft microbiological contaminations, as well extended storage time. Organ culture was originally introduced in order to extend cornea storage time to more than 10-14 days, a duration beyond which +4ºC techniques no longer ensure the viability of endothelial cells. However, owing to the high temperature involved, organ culture presents a greater risk of micro-organism development. So although it is well known that reducing storage time increases endothelial viability, corneas are not usually delivered by the banks until they have spent at least 10-12 days in organ culture, the period required to reveal any bacterial or fungal contamination using conventional bacteriological techniques and/or to observe any macroscopic changes in the storage medium. Microbiological controls are typically performed using standard bacteriological media in aerobic and anaerobic atmospheres, and Sabouraud broth. Micro-organism development is monitored by daily visual inspections of the inoculated media.

Parçanın beşinci cümlesinde geçen "although it is well known" ifadesinin Türkçe karşılığı aşağıdakilerden hangisidir?

• İyi bilindiği varsayılan
• Pek iyi bilinmemekle beraber
• İyi bilinmesi nedeniyle
• Öylesine iyi bilinen
• İyi bilinmesine rağmen

Severe tricuspid valve regurgitation (TR) occurs with other congenital heart defects, typically after repair of right-sided obstructive lesions. Forty-one children, aged 5 months to 22 years (mean, 10 years) underwent 42 De Vega tricuspid annuloplasties for moderate or severe TR during correction of other heart defects. Some patients had prior repair of tetralogy of Fallot or pulmonary atresia, or both (19 patients), double-outlet right ventricle (6 patients), pulmonary stenosis (4 patients), pulmonary atresia and intact ventricular septum (3 patients), complete atrioventricular septal defect (3 patients), and other diagnoses (6 patients). At the time of the De Vega, 37 patients (88%) had pulmonary valve replacement or right ventricular to pulmonary artery conduit replacement. Other procedures included aortic or mitral repair or replacement (6 patients), atrial septal defect and ventricular septal defect closure (5 patients), pulmonary arterioplasty (6 patients) and, tracheoplasty (1 patient). Early post repair echocardiography quantified TR as absent or mild (34 patients; 81%) mild-to-moderate (4 patients), moderate (3 patients), and severe (1 patient).

Parçaya göre, ciddi TR aşağıdaki durumlardan hangisiyle ilişkili olarak görülür?

• Her türlü regürjitasyon ile
• Travmalardan sonra
• Onarılmamış tıkayıcı lezyonlarıyla
• Sağ tarafta tıkayıcı lezyon onarımından sonra
• Aort kapakçığı işlev bozukluğuyla

Severe tricuspid valve regurgitation (TR) occurs with other congenital heart defects, typically after repair of right-sided obstructive lesions. Forty-one children, aged 5 months to 22 years (mean, 10 years) underwent 42 De Vega tricuspid annuloplasties for moderate or severe TR during correction of other heart defects. Some patients had prior repair of tetralogy of Fallot or pulmonary atresia, or both (19 patients), double-outlet right ventricle (6 patients), pulmonary stenosis (4 patients), pulmonary atresia and intact ventricular septum (3 patients), complete atrioventricular septal defect (3 patients), and other diagnoses (6 patients). At the time of the De Vega, 37 patients (88%) had pulmonary valve replacement or right ventricular to pulmonary artery conduit replacement. Other procedures included aortic or mitral repair or replacement (6 patients), atrial septal defect and ventricular septal defect closure (5 patients), pulmonary arterioplasty (6 patients) and, tracheoplasty (1 patient). Early post repair echocardiography quantified TR as absent or mild (34 patients; 81%) mild-to-moderate (4 patients), moderate (3 patients), and severe (1 patient).

Parçada kaç hastaya De Vega tekniğinin uygulandığı söylenmektedir?

• 5
• 10
• 22
• 37
• 41

Severe tricuspid valve regurgitation (TR) occurs with other congenital heart defects, typically after repair of right-sided obstructive lesions. Forty-one children, aged 5 months to 22 years (mean, 10 years) underwent 42 De Vega tricuspid annuloplasties for moderate or severe TR during correction of other heart defects. Some patients had prior repair of tetralogy of Fallot or pulmonary atresia, or both (19 patients), double-outlet right ventricle (6 patients), pulmonary stenosis (4 patients), pulmonary atresia and intact ventricular septum (3 patients), complete atrioventricular septal defect (3 patients), and other diagnoses (6 patients). At the time of the De Vega, 37 patients (88%) had pulmonary valve replacement or right ventricular to pulmonary artery conduit replacement. Other procedures included aortic or mitral repair or replacement (6 patients), atrial septal defect and ventricular septal defect closure (5 patients), pulmonary arterioplasty (6 patients) and, tracheoplasty (1 patient). Early post repair echocardiography quantified TR as absent or mild (34 patients; 81%) mild-to-moderate (4 patients), moderate (3 patients), and severe (1 patient).

Parçaya göre, daha önce ameliyat yapılmış olan bazı hastalarda en sık ameliyat nedeni aşağıdakilerden hangisidir?

• Sadece Fallot tetralojisi
• Çift çıkışlı sağ karıncık
• Pulmoner stenoz
• Fallot ve pulmoner atrezi beraber
• Pulmoner atrezi ve sağlam karıncık septumu

Severe tricuspid valve regurgitation (TR) occurs with other congenital heart defects, typically after repair of right-sided obstructive lesions. Forty-one children, aged 5 months to 22 years (mean, 10 years) underwent 42 De Vega tricuspid annuloplasties for moderate or severe TR during correction of other heart defects. Some patients had prior repair of tetralogy of Fallot or pulmonary atresia, or both (19 patients), double-outlet right ventricle (6 patients), pulmonary stenosis (4 patients), pulmonary atresia and intact ventricular septum (3 patients), complete atrioventricular septal defect (3 patients), and other diagnoses (6 patients). At the time of the De Vega, 37 patients (88%) had pulmonary valve replacement or right ventricular to pulmonary artery conduit replacement. Other procedures included aortic or mitral repair or replacement (6 patients), atrial septal defect and ventricular septal defect closure (5 patients), pulmonary arterioplasty (6 patients) and, tracheoplasty (1 patient). Early post repair echocardiography quantified TR as absent or mild (34 patients; 81%) mild-to-moderate (4 patients), moderate (3 patients), and severe (1 patient).

Parçaya göre, De Vega tekniği uygulaması sırasında aşağıdaki işlemlerden hangisi en sık yapılmıştır?

• Mitral replasman
• Aort düzelmesi
• Pulmoner kapak replasmanı
• Atrial septal defek kapatılması
• Trakeoplasti

Severe tricuspid valve regurgitation (TR) occurs with other congenital heart defects, typically after repair of right-sided obstructive lesions. Forty-one children, aged 5 months to 22 years (mean, 10 years) underwent 42 De Vega tricuspid annuloplasties for moderate or severe TR during correction of other heart defects. Some patients had prior repair of tetralogy of Fallot or pulmonary atresia, or both (19 patients), double-outlet right ventricle (6 patients), pulmonary stenosis (4 patients), pulmonary atresia and intact ventricular septum (3 patients), complete atrioventricular septal defect (3 patients), and other diagnoses (6 patients). At the time of the De Vega, 37 patients (88%) had pulmonary valve replacement or right ventricular to pulmonary artery conduit replacement. Other procedures included aortic or mitral repair or replacement (6 patients), atrial septal defect and ventricular septal defect closure (5 patients), pulmonary arterioplasty (6 patients) and, tracheoplasty (1 patient). Early post repair echocardiography quantified TR as absent or mild (34 patients; 81%) mild-to-moderate (4 patients), moderate (3 patients), and severe (1 patient).

Parçaya göre, erken post ekokardiyografi bulgularından en sık görüleni aşağıdakilerden hangisidir?

• TR yok veya hafif
• TR hafif–orta
• TR orta
• TR ağır
• TR ve ek bulgu

Anaphylaxis is a sudden, potentially life-threatening allergic reaction. Allergic reactions can be triggered by foods, medications, latex, or insect stings. The severity of anaphylactic reactions can be minimized by recognizing the symptoms early, having the proper medications available for self-treatment, and seeking emergency medical care promptly. It is also important to try to identify the specific trigger for each person, although this is not always possible. Anaphylaxis occurs when a trigger activates immune cells, which then release large amounts of multiple substances, including histamine, into the blood stream. This sets off a number of reactions, including itching, dilated blood vessels (leading to low blood pressure and rapid heart rate), mucus secretion, stimulation of the nervous system, and activation of other cells of the immune system. Children are more likely than adults to have anaphylactic reactions to foods. Adults are more likely to have anaphylactic reactions to antibiotics, radiocontrast media, insect stings, anaesthetic drugs, and certain intravenous medicines.

Parçada alerjiyi tetikleyen etkenler arasında aşağıdakilerden hangisi sayılmamıştır?

• Böcek sokması
• Gıda
• İlaç
• Lateks
• Polen

Anaphylaxis is a sudden, potentially life-threatening allergic reaction. Allergic reactions can be triggered by foods, medications, latex, or insect stings. The severity of anaphylactic reactions can be minimized by recognizing the symptoms early, having the proper medications available for self-treatment, and seeking emergency medical care promptly. It is also important to try to identify the specific trigger for each person, although this is not always possible. Anaphylaxis occurs when a trigger activates immune cells, which then release large amounts of multiple substances, including histamine, into the blood stream. This sets off a number of reactions, including itching, dilated blood vessels (leading to low blood pressure and rapid heart rate), mucus secretion, stimulation of the nervous system, and activation of other cells of the immune system. Children are more likely than adults to have anaphylactic reactions to foods. Adults are more likely to have anaphylactic reactions to antibiotics, radiocontrast media, insect stings, anaesthetic drugs, and certain intravenous medicines.

Parçaya göre, anaflaktik reaksiyonların ağırlığı aşağıdakilerden hangisiyle azaltılabilir?

• Etkenin saptanması
• Sürekli tedavi
• Erken tanı
• Ailevi yatkınlığın saptanması
• Kişinin yatkınlığının saptanması

Anaphylaxis is a sudden, potentially life-threatening allergic reaction. Allergic reactions can be triggered by foods, medications, latex, or insect stings. The severity of anaphylactic reactions can be minimized by recognizing the symptoms early, having the proper medications available for self-treatment, and seeking emergency medical care promptly. It is also important to try to identify the specific trigger for each person, although this is not always possible. Anaphylaxis occurs when a trigger activates immune cells, which then release large amounts of multiple substances, including histamine, into the blood stream. This sets off a number of reactions, including itching, dilated blood vessels (leading to low blood pressure and rapid heart rate), mucus secretion, stimulation of the nervous system, and activation of other cells of the immune system. Children are more likely than adults to have anaphylactic reactions to foods. Adults are more likely to have anaphylactic reactions to antibiotics, radiocontrast media, insect stings, anaesthetic drugs, and certain intravenous medicines.

Parçaya göre, kan damarlarının genişlemesi aşağıdakilerden hangisine yol açmaktadır?

• Yavaş kalp atımı
• Ciltte kızarıklık
• Hızlı solunum
• Düşük kan basıncı
• Düzensiz nabız

Anaphylaxis is a sudden, potentially life-threatening allergic reaction. Allergic reactions can be triggered by foods, medications, latex, or insect stings. The severity of anaphylactic reactions can be minimized by recognizing the symptoms early, having the proper medications available for self-treatment, and seeking emergency medical care promptly. It is also important to try to identify the specific trigger for each person, although this is not always possible. Anaphylaxis occurs when a trigger activates immune cells, which then release large amounts of multiple substances, including histamine, into the blood stream. This sets off a number of reactions, including itching, dilated blood vessels (leading to low blood pressure and rapid heart rate), mucus secretion, stimulation of the nervous system, and activation of other cells of the immune system. Children are more likely than adults to have anaphylactic reactions to foods. Adults are more likely to have anaphylactic reactions to antibiotics, radiocontrast media, insect stings, anaesthetic drugs, and certain intravenous medicines.

Parçada immün hücrelerin uyarılmasına bağlı olarak gelişen reaksiyonlar arasında aşağıdakilerden hangisi sayılmamıştır?

• Sinir sisteminin uyarılması
• Baygınlık
• Mukus salgısı
• Kaşıntı
• İmmün sistemin diğer hücrelerinde uyarım

Anaphylaxis is a sudden, potentially life-threatening allergic reaction. Allergic reactions can be triggered by foods, medications, latex, or insect stings. The severity of anaphylactic reactions can be minimized by recognizing the symptoms early, having the proper medications available for self-treatment, and seeking emergency medical care promptly. It is also important to try to identify the specific trigger for each person, although this is not always possible. Anaphylaxis occurs when a trigger activates immune cells, which then release large amounts of multiple substances, including histamine, into the blood stream. This sets off a number of reactions, including itching, dilated blood vessels (leading to low blood pressure and rapid heart rate), mucus secretion, stimulation of the nervous system, and activation of other cells of the immune system. Children are more likely than adults to have anaphylactic reactions to foods. Adults are more likely to have anaphylactic reactions to antibiotics, radiocontrast media, insect stings, anaesthetic drugs, and certain intravenous medicines.

Parçada anaflaktik reaksiyonların çocuklarda en sık aşağıdakilerden hangisine bağlı olarak meydana geldiği söylenmektedir?

• Anestetik ilaçlar
• Antibiyotikler
• Radyokontrast madde
• Böcek sokması
• Gıdalar

As the economic burden of gastroesophageal reflux disease (GERD) is largely weighted to maintenance as opposed to initial therapy, switching from more potent to less expensive medication once symptoms are alleviated (step-down therapy) may prove to be most cost-effective. In a recent study, it is aimed to prospectively evaluate the feasibility of step-down therapy in a cohort of patients with symptoms of uncomplicated GERD. Patients whose GERD symptoms were alleviated by proton pump inhibitors (PPIs) were recruited from outpatient general medicine clinics. After baseline demographic and quality of life information were obtained, PPls were withdrawn from subjects in a stepwise fashion. Primary outcome was recurrence of symptoms during follow-up that required reinstitution of PPls. Secondary outcomes included changes in quality of life and overall cost of management.

Parçaya göre, reflünün yol açtığı en önemli ekonomik sıkıntı aşağıdakilerden hangisidir?

• Hastanın çalışma yaşamını aksatması
• Tedavide kullanılacak ilaç sayısının fazla oluşu
• Tanının pahalı oluşu
• Sürekli tedavinin pahalı oluşu
• Hastanın acil bakım gerektirmesi

As the economic burden of gastroesophageal reflux disease (GERD) is largely weighted to maintenance as opposed to initial therapy, switching from more potent to less expensive medication once symptoms are alleviated (step-down therapy) may prove to be most cost-effective. In a recent study, it is aimed to prospectively evaluate the feasibility of step-down therapy in a cohort of patients with symptoms of uncomplicated GERD. Patients whose GERD symptoms were alleviated by proton pump inhibitors (PPIs) were recruited from outpatient general medicine clinics. After baseline demographic and quality of life information were obtained, PPls were withdrawn from subjects in a stepwise fashion. Primary outcome was recurrence of symptoms during follow-up that required reinstitution of PPls. Secondary outcomes included changes in quality of life and overall cost of management.

Parçada sözü edilen çalışmaya alınan hastalar kimler arasından seçilmiştir?

• Yatan hastalar
• Genel kliniklerde ayakta tedavi edilenler
• Bakım evlerinde kalanlar
• Gastroenteroloji kliniklerine başvuranlar
• Gazete ilanıyla ulaşılanlar

As the economic burden of gastroesophageal reflux disease (GERD) is largely weighted to maintenance as opposed to initial therapy, switching from more potent to less expensive medication once symptoms are alleviated (step-down therapy) may prove to be most cost-effective. In a recent study, it is aimed to prospectively evaluate the feasibility of step-down therapy in a cohort of patients with symptoms of uncomplicated GERD. Patients whose GERD symptoms were alleviated by proton pump inhibitors (PPIs) were recruited from outpatient general medicine clinics. After baseline demographic and quality of life information were obtained, PPls were withdrawn from subjects in a stepwise fashion. Primary outcome was recurrence of symptoms during follow-up that required reinstitution of PPls. Secondary outcomes included changes in quality of life and overall cost of management.

Parçaya göre, çalışmaya alınan hastalarda PPl’lar nasıl bırakılmıştır?

• Basamaklı olarak
• İsteğe bağlı olarak
• Hızla
• Kurayla
• Plaseboyla

As the economic burden of gastroesophageal reflux disease (GERD) is largely weighted to maintenance as opposed to initial therapy, switching from more potent to less expensive medication once symptoms are alleviated (step-down therapy) may prove to be most cost-effective. In a recent study, it is aimed to prospectively evaluate the feasibility of step-down therapy in a cohort of patients with symptoms of uncomplicated GERD. Patients whose GERD symptoms were alleviated by proton pump inhibitors (PPIs) were recruited from outpatient general medicine clinics. After baseline demographic and quality of life information were obtained, PPls were withdrawn from subjects in a stepwise fashion. Primary outcome was recurrence of symptoms during follow-up that required reinstitution of PPls. Secondary outcomes included changes in quality of life and overall cost of management.

Parçaya göre, yapılan çalışmanın ikincil sonucu aşağıdakilerden hangisidir?

• Ailelerin yaklaşımında değişiklik
• Belirtilerin artması
• Yaşam kalitesinde ve toplam giderdeki değişiklikler
• Yeni yakınmalar
• İş ve güç kaybı

As the economic burden of gastroesophageal reflux disease (GERD) is largely weighted to maintenance as opposed to initial therapy, switching from more potent to less expensive medication once symptoms are alleviated (step-down therapy) may prove to be most cost-effective. In a recent study, it is aimed to prospectively evaluate the feasibility of step-down therapy in a cohort of patients with symptoms of uncomplicated GERD. Patients whose GERD symptoms were alleviated by proton pump inhibitors (PPIs) were recruited from outpatient general medicine clinics. After baseline demographic and quality of life information were obtained, PPls were withdrawn from subjects in a stepwise fashion. Primary outcome was recurrence of symptoms during follow-up that required reinstitution of PPls. Secondary outcomes included changes in quality of life and overall cost of management.

Parçanın beşinci cümlesinde geçen "required" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Önleyen
• Tanımlayan
• Saptayan
• Değerlendiren
• Gerektiren